Clinical Scenario: New Management in Hypertrophic Cardiomyopathy (HCM)

Question:
“A 32-year-old male, known to have Hypertrophic Obstructive Cardiomyopathy (HOCM), presents with worsening dyspnea (NYHA Class III) despite being on a maximal tolerated dose of Bisoprolol and Verapamil. His LVOT gradient is 55 mmHg at rest.

What is the next most appropriate pharmacological step according to the latest 2024/2025 updates?

A. Add Disopyramide
B. Increase Beta-blocker dose
C. Start Mavacamten
D. Urgent Alcohol Septal Ablation
E. Refer for Myectomy