Hello! Thank you for your question on HCM! I understand your concern, and would like to explain that acute episodes of confusion are normal in persons affected from dementia. The cardiac tests, have resulted normal, and we can exclude this as a possible cause of this confusional state. Regarding the small white spots in her brain, they indicate for a small vessel disease causing a vascular dementia. They are not related to any cardiac cause, but to high blood pressure or diabetes. Dementia is a progressive disorder, which is treated with different neurotropic drugs (donepezil, rivastigmine, memantine) and to help maintain as much as possible an adequate cognitive function and a lot of emotional support is needed. Unfortunately the situation deteriorates progressively. Antipsychotic drugs may be necessary in case of frequent confusion episodes. Hope to have been helpful! Greetings! Dr. Iliri