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Patient handout

NSTEMI in hypertrophic cardiomyopathy — microvascular ischemia + supply-demand mismatch

PRODUCTION

1. Your condition

This handout is for nstemi in hypertrophic cardiomyopathy — microvascular ischemia + supply-demand mismatch. Your care team identified this based on: patient with known hypertrophic cardiomyopathy (resting or provocable lvot gradient ≥30 mmhg, septal thickness ≥15 mm) presenting with ischemic chest pain + hstn rise/fall + non-st-elevation ecg — microvascular ischemia / supply-demand crisis on differential.

Other reasons your team may use this plan: nste-acs workup angiogram shows unobstructed epicardial coronaries + bedside echo reveals asymmetric septal hypertrophy (≥15 mm) with sam and dynamic lvot gradient → hcm-microvascular nstemi substrate; stress cmr shows first-pass perfusion defect + mid-wall lge in hypertrophied septum + unobstructed epicardial coronaries — confirms hcm-microvascular mi substrate per petersen 2007 pmid 17502574; new-onset afib with rapid ventricular response in hcm patient + hstn rise/fall + non-st-elevation ecg — loss of atrial kick destabilizes lv filling → subendocardial ischemia / supply-demand mismatch in stiff hypertrophied lv.

2. Your medications

Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.

MedicationStarting doseHowWhenWhat it does
phenylephrine50-200 mcg IV bolus or 0.5-3 mcg/kg/min infusion titrate to MAP ≥65IVbolus or continuous infusionPure α-agonist increases afterload → reduces LVOT gradient by improving aortic ejection and abolishing SAM → relieves microvascular ischemia by improving subendocardial perfusion gradient; preferred over norepinephrine (β-component worsens obstruction) and ABSOLUTELY preferred over inotropes
esmolol500 mcg/kg IV bolus then 50-300 mcg/kg/min infusion titrate to HR <80IVcontinuous infusionShort-acting cardioselective β-blocker lengthens diastolic filling time + reduces inotropy → reduces LVOT gradient → improves subendocardial perfusion → relieves microvascular ischemia; titratable, off rapidly if hemodynamic compromise
aspirin81 mg daily (no high-dose load if no atherosclerotic substrate identified) OR 162-325 mg load if concurrent atherosclerotic NSTEMI on imagingPOdaily indefinitelyASA monotherapy reasonable in HCM-microvascular NSTEMI (no plaque rupture substrate); some authors continue indefinitely for general cardiovascular risk reduction; DAPT NOT routine (reserve P2Y12 only if concurrent atherosclerotic CAD on imaging) — different from atherosclerotic NSTEMI default
metoprolol_succinate25-50 mg PO daily titrate to maximally tolerated (target HR 60-80)POdailyACC/AHA 2024 HCM Class I — first-line chronic β-blockade for symptomatic HCM; reduces inotropy + lengthens diastole → reduces LVOT gradient → improves microvascular perfusion
carvedilol3.125 mg BID titrate to max tolerated (target HR 60-80)POBID indefinitelyACC/AHA 2024 HCM Class I alternative; α1-blockade caution in obstructive HCM with very high gradient (vasodilator effect may worsen gradient — start low) — prefer metoprolol succinate as first choice in pure HOCM
verapamil120 mg PO daily extended-release titrate to 480 mg/d maxPOdaily ERACC/AHA 2024 HCM Class I alternative — non-DHP CCB; CAUTION in obstructive HCM with very high gradient or heart failure (vasodilator effect can worsen gradient — start low); improves diastolic relaxation and microvascular perfusion
disopyramide40-50 mg PO TID-QID extended-release titrate to 600-800 mg/d max; renal-adjustedPOTID-QIDACC/AHA 2024 HCM Class IIa — negative inotrope reduces SAM and LVOT gradient → improves microvascular perfusion; QT prolongation + anticholinergic effects + proarrhythmic — monitor QT, K, Mg
mavacamten5 mg PO daily start; titrate q4w per echo per REMS (max 15 mg/d)POdailyACC/AHA 2024 HCM Class IIa — first-in-class cardiac myosin inhibitor; EXPLORER-HCM PMID 32861276 (Olivotto Lancet 2020): 30% relative improvement in pVO2 + ~47% reduction in resting LVOT gradient; VALOR-HCM 2023: reduces septal reduction therapy referrals; REMS program — echo q4w during titration to detect LVEF drop <50%
apixaban5 mg PO BID (2.5 mg BID per FDA dose-reduction criteria)POBID indefiniteACC/AHA 2024 HCM Class I — ANY AF in HCM = anticoagulate regardless of CHA2DS2-VASc score; DOAC preferred over warfarin; ARISTOTLE class evidence applies
rivaroxaban20 mg PO daily with food (15 mg if CrCl 15-50)POdaily indefiniteACC/AHA 2024 HCM Class I — DOAC alternative for AF in HCM

Plan: HCM-microvascular NSTEMI regimen — overrides parent cardio.nstemi.core.v1 vasodilator + DAPT + statin defaults; uses BB or non-DHP CCB + ASA monotherapy + AC for AF (Class I regardless of CHA2DS2-VASc); chronic ladder: BB/CCB → disopyramide → mavacamten → septal reduction therapy — ACC/AHA 2024 HCM Guideline (Ommen) + ESC 2023 cardiomyopathies (Arbelo PMID 37622666) + EXPLORER-HCM (Olivotto PMID 32861276)

3. When to call your provider

Contact your care team if any of the following happen:

  • Symptomatic progression → escalate medical therapy or septal reduction therapy
  • New VT/VF or syncope → urgent EP / ICD evaluation
  • New AF → STAT AC initiation regardless of CHA2DS2-VASc
  • End-stage dilated phenotype (heart pumping strength (LVEF) <50%) → switch to cardio.hfref.core.v1 for the four foundational heart-failure medications 4-pillar

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

  • HCM-microvascular NSTEMI patient given inadvertent inotrope (dobutamine, milrinone, epinephrine drip) for hypotension — paradoxically worsens SAM-mediated LVOT obstruction with cardiovascular collapse + worsens subendocardial ischemia(life-threatening)
  • NTG, ACEi, ARB, ARNI, or DHP-CCB (amlodipine) administered to HCM-microvascular NSTEMI patient — drops afterload → worsens LVOT gradient → worsens subendocardial perfusion → worsens microvascular ischemia
  • New-onset AFib with rapid ventricular response in HCM-microvascular NSTEMI patient — loss of atrial kick + tachycardia → catastrophic drop in LV filling because stiff hypertrophied LV depends on atrial systole → worsens subendocardial ischemia(life-threatening)
  • HCM-microvascular NSTEMI patient with persistent NYHA III-IV symptoms + LVOT gradient ≥50 mmHg at rest or with provocation despite maximally tolerated medical therapy (BB or CCB ± disopyramide ± mavacamten) — septal reduction therapy referral
  • HCM-microvascular NSTEMI patient on mavacamten with REMS echo showing heart pumping strength (LVEF) drop <50% during titration — REMS-mandated dose reduction or discontinuation
  • HCM-microvascular NSTEMI patient with unexplained syncope, NSVT on Holter, family history of SCD, LV thickness ≥30 mm, apical aneurysm on CMR, or high LGE burden (>15% LV mass) — primary-prevention ICD indication

5. Follow-up

HCM specialist clinic within 1-2 weeks; cascade family genetic counseling + screening (50% autosomal dominant inheritance per ACC/AHA 2024); mavacamten REMS echo q4w during titration then q12w maintenance; ICD/septal reduction decision finalized per SCD criteria; AC continuation indefinite if AF; sports clearance shared decision; cardiac rehab if NYHA II-III (modified intensity — avoid heavy isometric exercise); long-term cardiology surveillance

6. Sources

Guideline: ACC/AHA 2024 HCM Guideline (Ommen) + ESC 2023 cardiomyopathies (Arbelo PMID 37622666) + ESC 2014 HCM (Elliott PMID 25173338) for SCD risk + 2025 ACC/AHA ACS Guideline (Rao) for parent ACS arc

  1. pubmed.ncbi.nlm.nih.gov/37622666
  2. pubmed.ncbi.nlm.nih.gov/25173338
  3. pubmed.ncbi.nlm.nih.gov/32861276