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HCM with Atrial Fibrillation — EECC MCQ

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EasyCardiomyopathyHCM with Atrial FibrillationEECC

A 40-year-old man with HCM and atrial fibrillation has a CHA2DS2-VA score of 0. According to the 2023 ESC Cardiomyopathy Guidelines, what is the anticoagulation recommendation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Anticoagulation is recommended regardless of CHA2DS2-VA score

Explanation lettering: E = shown as A · A = shown as B · B = shown as E

Per the 2023 ESC Cardiomyopathy Guidelines, anticoagulation is recommended in all patients with HCM who develop AF, regardless of CHA2DS2-VASc or CHA2DS2-VA score (Class I, LOE B). HCM carries intrinsically high thromboembolic risk. The same applies to cardiac amyloidosis with AF. Aspirin (C) is not sufficient. Waiting for an event (E) would be too late.

Reference: ESC (2023): Guidelines for the Management of Cardiomyopathies