ESC HCM SCD Risk Score

5-Year SCD Risk (HCM)

2.69%

Low Risk

Age (Years)

Max Wall Thickness (mm)

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

Risk stratification for sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM) aged ≥16 years.

Decision-making for primary prevention implantable cardioverter-defibrillator (ICD) implantation.

Baseline assessment at initial diagnosis and periodic reassessment (every 1-2 years or with clinical change).

Pre-participation cardiovascular screening in athletes with known or suspected HCM.

Evaluation of family members with genotype-positive/phenotype-negative HCM for risk stratification.

Key Indication - Primary Prevention ICD Decision

The ESC HCM SCD Risk Score is recommended by the 2014 ESC Guidelines on Diagnosis and Management of Hypertrophic Cardiomyopathy to estimate 5-year risk of SCD. A score ≥6% (high risk) is a Class IIa indication for ICD implantation; 4-6% (intermediate risk) requires individualised decision; <4% (low risk) generally does not warrant ICD.

When Not to Use / Contraindications

Patients with prior cardiac arrest or sustained ventricular tachycardia (secondary prevention indication).

Children <16 years of age (use HCM Risk-Kids score instead).

Patients with HCM phenocopies (e.g., Fabry disease, Danon disease, Noonan syndrome) – score not validated.

Patients with left ventricular ejection fraction <50% (end-stage HCM) – alternative risk stratification needed.

Patients with recent myectomy or alcohol septal ablation – score may not reflect post-procedural risk.

Last Comprehensive Review: 2026

Recent Journal Updates

WHO NewsJun 23, 2026

WHO urges scale up of newborn screening to improve early detection and care of birth defects

Clinical Context

We think this has broad domain relevance to ESC HCM SCD Risk Score.

PLOS MedicineJun 23, 2026

Comparisons of core component delivery in cardiac rehabilitation programs by country income classification and decade based on the 2025 Global Audit Update: A survey study

Clinical Context

We think this has broad domain relevance to ESC HCM SCD Risk Score.

FDA MedWatchJun 22, 2026

Heart Pump Controller Correction: Abiomed Updates Use Instructions for Automated Impella Controllers

Clinical Context

We think this has broad domain relevance to ESC HCM SCD Risk Score.