Which treatment option is considered first-line for hypertrophic cardiomyopathy?

The first-line treatment for hypertrophic cardiomyopathy is beta-blockers. These medications work by reducing heart rate and myocardial contractility, which can help alleviate symptoms of obstruction and improve exercise capacity in patients. When patients present with symptoms of left ventricular outflow obstruction, such as dyspnea on exertion or chest pain, beta-blockers can effectively manage these symptoms by decreasing the heart's demand for oxygen and allowing more time for the left ventricle to fill.

In hypertrophic cardiomyopathy, one of the key complications is the potential for arrhythmias, which can be exacerbated by increased heart rate. By utilizing beta-blockers, not only do these agents help to manage the hypertrophic obstructive physiology, but they can also provide a protective effect against arrhythmias, making them a suitable first-line pharmacological approach.

Other treatment options like surgical myomectomy and alcohol septal ablation are reserved for more severe cases where pharmacological management is not sufficient and significant left ventricular outflow tract obstruction is present. Implantable cardioverter-defibrillators (ICDs) are typically indicated for secondary prevention in patients who have experienced life-threatening arrhythmias or have high-risk features rather than as a first-line option in managing hypertrophic