Secons most frequent CM, incidence of 0.24 to 0.47/ 100.000, 69% males, majority by 75% are familial/ genetic. Pediatric HCM is heterogenous, associated to genetic syndrome in some cases, multidisciliplary team is needed to control these patients. Symtomps are related with obstruction of LVOT, so periodically echo are needed in the follow-up. Chest pain, syncope or exertional dyspnea could be related with acute obstruction of LVOT and arrhythmias could cause sudden death. Beta-blockers are the first therapy to control LVOT obstruction (disopyramide and verapamil in teenagers or adults patients are alternatives). Surgical approach has to be considered if symptomps persist despite medical therapy

Sudden death (SD) risk is well stablish in adults, European Society of Cardiology (ESC) has endorsed the use of a new SCD risk prediction model (HCM Risk-SCD) (O’Mahony C et al. Eur Heart J 2014; 35: 2010–2020). Provides individualized estimate for 5–year SCD risk by utilizing predictor variables associated with multivariable analyses.

Better risk stratification to identify patients at risk for worse outcome is needed in pediatric HCM. In adult HCM patients, a blunted blood pressure response on exercise testing and elevations in cardiac troponins has been identified as risk factors for worse outcome, but these have not been evaluated in children. Algorithms of SD have not been validated in children and younger teenagers (Norrish G et al, Eur J Cardiol 2017;24:1220-1230).