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HCM Risk-SCD Calculator — EECC MCQ

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ModerateCardiomyopathyHCM Risk-SCD CalculatorEECC

A 48-year-old man with HCM and maximum wall thickness of 30 mm is assessed for sudden cardiac death risk using the ESC HCM Risk-SCD calculator. His estimated 5-year SCD risk is 7.2%. According to ESC guidelines, what does this indicate?

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Correct answer: D — A 5-year SCD risk ≥6% is considered high risk; ICD implantation is recommended (Class IIa)

The ESC HCM Risk-SCD calculator estimates 5-year risk of SCD using clinical variables: age, maximal wall thickness, LA diameter, maximal LVOT gradient, family history of SCD, NSVT, and unexplained syncope. The 2023 ESC Cardiomyopathy Guidelines stratify risk: <4% = low (ICD generally not indicated); 4-6% = intermediate (ICD may be considered, Class IIb, taking into account LGE extent, apical aneurysm); ≥6% = high (ICD should be considered, Class IIa). At 7.2%, this patient falls in the high-risk category. Additional risk modifiers not in the calculator (extensive LGE >15% of LV mass, LV apical aneurysm, LVEF <50%) may further strengthen the ICD indication.

Reference: ESC (2023): Guidelines on Cardiomyopathies