What is the gold standard for diagnosing hypertrophic cardiomyopathy (HCM)?

The gold standard for diagnosing hypertrophic cardiomyopathy (HCM) is indeed the echocardiogram. An echocardiogram provides detailed images of the heart's structure, allowing for visualization of the thickened heart muscle, which is a hallmark of HCM. It helps in assessing the left ventricular wall thickness and can also evaluate outflow obstruction and diastolic function, both of which are critical components in diagnosing and managing HCM.

While a cardiac MRI is a valuable tool that offers excellent tissue characterization and can provide additional insights about the extent of hypertrophy and potential scar tissue, an echocardiogram remains the primary and most commonly used diagnostic method. MRI is often considered when echocardiographic results are inconclusive or when there is a need for more detailed assessment of cardiac morphology.

Chest X-rays and CT scans are not standard for diagnosing HCM as they do not provide the level of detail needed to assess myocardial thickness or function related directly to hypertrophic cardiomyopathy. They may be utilized for evaluating overall heart size or to rule out other pathologies but lack the specificity necessary for HCM diagnosis.