hypertrophic cardiomyopathy

[baseballfan]

What are the current recommendations for screening of children with a parent who has HOCM? My children are 10, 12, and 15. All were screened 2 years ago. Two of the 3 are very physically active and into competitive sports (baseball and basketball). If found to have HOCM, will they be advised to eliminate all competitive sports or are there times when they are allowed to continue unless symptomatic? Mine is the only case documented in our family and I am very symptomatic. There is no sudden cardiac death, but I do have an AICD for ventricular arrythmias. Thank you for your time.

[CCF-M.D.-RCJ]

baseballfan,

Thanks for the post.

The following is an excerpt from the ACC guidelines (see http://www.acc.org/clinical/consensus/cardiomyopathy/index.pdf)

"Clinical screening of first-degree relatives and other
family members should be encouraged. Therefore, when a
DNA-based diagnosis is not feasible, the recommended
clinical strategies for screening family members employ
history and physical examination, 12-lead ECG, and twodimensional
echocardiography at annual evaluations during
adolescence (12 to18 years of age). Due to the possibility of
delayed adult-onset LVH, it is reasonable and prudent to
recommend that adult relatives with normal echocardiograms
at or beyond age 18 have subsequent clinical studies
performed about every five years. Screening in relatives younger
than age 12 is not usually pursued systematically unless the
child has a high-risk family history or is involved in particularlyintense competitive sports programs. Affected patients identified through family screening (or otherwise) are conventionally evaluated on approximately a 12- to 18-month basis."

The decision to stop sports is made on an individualized basis, although that recommendation is often made.

Hope that helps.