2026 Expert Consensus Recommendations on Hypertrophic Cardiomyopathy: A Report of the Task Force of the Taiwan Society of Cardiology.

Hypertrophic cardiomyopathy (HCM) is the most common genetic heart disease worldwide. However, only a small percentage of cases are diagnosed clinically, suggesting under-recognition, with most clinicians exposed to small segments of the broad disease spectrum, in which effort intolerance, heart failure, arrhythmias, and sudden cardiac death can occur. Comprehensive evaluations and longitudinal assessments with echocardiography, ambulatory electrocardiography, stress testing, and, in some cases, cardiac magnetic resonance imaging, are important for diagnosis, risk stratification, distinguishing obstructive from nonobstructive forms, and guiding therapy. Symptomatic patients can be treated with various medications, including a new class of cardiac myosin inhibitors. For patients whose symptoms do not respond to medical therapy or in whom medical therapy is not desired, invasive septal reduction therapy options, when performed at expert centers, have been shown to lead to successful outcomes. The Taiwan Society of Cardiology recently appointed a task force to formulate a consensus on HCM. Based on the most up-to-date information, the consensus emphasizes a comprehensive diagnostic approach, including imaging and genetic testing, family screening and risk assessment, and provides current evidence-based important recommendations to guide clinicians in the management of patients with HCM.