skip to main content

Exercise Prescription in Low-risk HCM — EECC MCQ

Instant feedback + full explanation. One question, done properly.

ModerateCardiomyopathyExercise Prescription in Low-risk HCMEECC

A 45-year-old man with newly diagnosed HCM asks whether he can continue recreational cycling. He has no high-risk features (MWT 18 mm, no LVOT obstruction, no family history of SCD, ESC HCM Risk-SCD <4%). What is the exercise advice?

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

Reveal the answer and explanation

Correct answer: B — Low-to-moderate intensity recreational exercise is generally permitted in low-risk HCM patients — the 2020 ESC Sports Cardiology Guidelines shifted from blanket prohibition to individualised risk-based exercise prescriptions; competitive high-intensity sport remains restricted

The 2020 ESC Sports Cardiology Guidelines represented a paradigm shift in exercise recommendations for HCM: moving from blanket prohibition of all competitive sport to a risk-stratified, individualised approach. For low-risk HCM patients (no major risk factors, no symptoms, no LVOT obstruction during exercise): (1) low-moderate intensity recreational exercise is generally permitted; (2) high-intensity competitive sport remains restricted; (3) exercise intensity should be discussed with the HCM specialist; (4) shared decision-making is emphasised. The rationale: the absolute risk of exercise-related SCD in low-risk HCM is very low, and the cardiovascular and psychological benefits of regular exercise outweigh the small incremental risk. High-risk features (SCD risk ≥6%, symptoms during exercise, LVOT obstruction ≥50 mmHg with exercise, severe LVH) warrant more restrictive recommendations.

Reference: ESC (2020): Sports Cardiology Guidelines; ESC (2023): Cardiomyopathies