<p class="first" id="d3818422e174">In an era of rapid technological development and
evolving diagnostic possibilities,
the electrocardiogram (ECG) is living an authentic "renaissance" in myocardial diseases.
To date, the ECG remains an irreplaceable first step when evaluating patients with
hypertrophic cardiomyopathy (HCM) and an abnormal ECG may be the only manifestation
of disease at an early stage. In some instances, specific electrical anomalies may
differentiate HCM from phenocopies such as cardiac amyloidosis and glycogen storage
diseases. The exponential growth in knowledge of the complexity of HCM has led to
new challenges in terms of early identification of the disease, differential diagnosis,
risk stratification, and development of targeted therapies. In this scenario, the
apparently "old fashioned" ECG and the array of ECG-based techniques, ranging from
Holter monitoring and loop recorders to exercise testing, are as contemporary as ever.
In the present review, we discuss the current role of the ECG in the diagnosis and
management of HCM, focusing on various clinical settings where its appropriate use
and interpretation can make a difference.
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