The comprehensive assessment of patients with hypertrophic cardiomyopathy is a complex process, with each step concurrently focusing on confirmation of the diagnosis, differentiation between sarcomeric and non-sarcomeric disease (phenocopy), and prognostication. Novel modalities such as genetic testing and advanced imaging have allowed for substantial advancements in the understanding of this condition and facilitate patient management. However, their availability is at present not universal, and interpretation requires a high level of expertise. In this setting, electrocardiography, a fast and widely available method, still retains a significant role in everyday clinical assessment of this population. In our review, we follow a stepwise approach for the interpretation of each electrocardiographic segment, discussing clinical implications of electrocardiographic patterns in sarcomeric disease, their value in the differential diagnosis from phenocopies, and impact on patient management. Outlining the substantial amount of information to be obtained from a simple tracing, we exhibit how electrocardiography is likely to remain an integral diagnostic tool in the future as well.

肥厚型心肌病患者的综合评估是一个复杂的过程，每个步骤同时关注诊断的确认、肌节和非肌节疾病的鉴别（表型）和预后。基因检测和先进成像等新方法使人们对这种疾病的理解有了实质性的进步，并促进了患者的管理。然而，它们的可用性目前并不普遍，解释需要高水平的专业知识。在这种情况下，心电图是一种快速且广泛可用的方法，在该人群的日常临床评估中仍然发挥着重要作用。在我们的审查中，我们采用逐步方法来解释每个心电图片段，讨论心电图模式在肌节疾病中的临床意义，它们在与表型检查鉴别诊断中的价值，以及对患者管理的影响。我们概述了从简单追踪中获得的大量信息，展示了心电图在未来如何可能仍然是一个不可或缺的诊断工具。