HCM BIBLE

The HCM Bible

From the day you hear "heart murmur", in the order you need it.

12 chapters · 17 documents · ACVIM 2020

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A living book. This isn't finished and won't be — ACVIM 2020 criteria change, and so does this. Treatments under review today may read differently in a year. Last updated 3 Oct 2026

Care companion Heart medicines & supplements

Part 1 · What to know first

01 The day of diagnosis The murmur · diagnosed without symptoms · what to do right now 3

The day of diagnosis — when they say the heart wall is thick When they hear a heart murmur — not every sound is disease Is HCM inherited? — Maine Coons, Ragdolls and genetic testing

02 Reading the numbers Wall thickness · left atrium (LA/Ao) · NT-proBNP · troponin 2

Reading the echo report — between 5 mm and 6 mm NT-proBNP — how much a blood test can say about the heart

03 Stage and goals ACVIM B1 · B2 · C · D — the left atrium decides 1

Between B1 and B2 — what the left atrium is saying

04 Saying goodbye Quality of life · decisions in an emergency · afterwards 1

Saying goodbye — for the farewell that comes without warning

With this disease, goodbyes can come without warning. So this chapter sits near the front, to be read in advance.

Part 2 · Managing

05 Understanding the medications Clopidogrel · diuretics · pimobendan · beta-blockers 2

Understanding the medications — the cardiac drugs as a timetable Clopidogrel — the most important half-tablet

06 Blood clots (ATE) Sudden hind-leg paralysis · prevention · emergency response · recurrence 1

NLR and PNR — the clot-risk signals hiding in an ordinary blood panel

07 Heart failure Pulmonary oedema · pleural effusion · adjusting diuretics · hospital and after 1

Heart failure — the manual, from the day the reservoir overflows

08 Managing symptoms Rising breathing rate · open-mouth breathing · fainting · hiding 1

Managing the signs — when a silent disease starts to speak

09 When another disease comes too With CKD (the diuretic tightrope) · thyroid · hypertension 1

When another disease comes too — old cats rarely carry one illness alone

Part 3 · Walking together

10 Doing it at home Counting resting breaths · low-stress living · giving the pills 2

Resting respiratory rate — one minute a day, the cheapest heart monitor Feeding the heart-disease cat — what comes before low salt

11 Getting the most from your vet Recheck intervals · where to get the echo · red flags 1

Getting the most from your vet — recheck rhythm, where to echo, and the emergency night

12 New treatments Rapamycin (Felycin) · genetic research 1

Rapamycin — the first drug aimed at the disease itself

Diagnosis and treatment belong with your own vet.