Hypertrophic cardiomyopathy (HCM) is an inherited disorder of cardiac sarcomeric proteins characterised by the presence of
myocardial hypertrophy in the absence of abnormal loading conditions. Individuals with HCM can remain asymptomatic throughout their
lives but many experience chest pain, symptoms of heart failure, syncope and sudden ventricular arrhythmias. Cardiopulmonary exercise
testing is an important part of the assessment of patients with HCM who often have reduced peak oxygen consumption and a lower anaerobic
threshold compared with healthy age-matched controls. This review will focus on mechanisms of exercise limitation, which are
complex and multifactorial, and the options for medical management.
Keywords: Hypertrophic cardiomyopathy, exercise capacity, heart failure, left ventricular tract obstruction, ischaemia, metabolism.
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