[Sudden death in hypertrophic myocardiopathy].

Sudden death is a very important event in the natural history of hypertrophic cardiomyopathy. Although its physiopathology is not still fully understood, there are several potential mechanisms to explain it, such as electrical, ischemic and hemodynamic events. It is thought that these mechanisms vary from patient to patient and that more than one mechanism may coexist in a specific patient. Risk factors for sudden death in hypertrophic cardiomyopathy are clinical, genetical and electrical. Risk stratification implies aggressive investigation (electrophysiological study and/or forearm plethysmography during exercise and/or tilt test) in order to identify the most probable mechanism involved in each case and to select individualized preventive measures (pharmacological, surgical, implantable cardioverter defibrillator). The role of amiodarone is still controversial because of contradictory results with this drug in this illness.