Hypertrophic Cardiomyopathy Treatment in India
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What is Hypertrophic Cardiomyopathy?
Hypertrophic Cardiomyopathy is a heart muscle disease characterised by abnormal thickening of the ventricular walls that cannot be explained solely by conditions such as high blood pressure or abnormal heart valves. In some patients, the thickened muscle obstructs blood flow from the heart, while in others, the disease is non-obstructive. HCM can be inherited and may occur at different ages.
What is the Importance of Timely Treatment?
Timely treatment of Hypertrophic Cardiomyopathy helps control symptoms, assess whether thickened heart muscle is obstructing blood flow, reduce the risk of complications such as heart failure and arrhythmias, and identify patients who may benefit from an implantable cardioverter-defibrillator (ICD). Regular follow-up also supports long-term heart health by guiding medicines, activity, lifestyle, and family screening.
What are the Common Symptoms of Hypertrophic Cardiomyopathy?
- Shortness of Breath: Breathlessness may occur during physical activity or, in more advanced cases, at rest.
- Chest Pain: Some patients experience chest discomfort, particularly during exertion.
- Palpitations: A sensation of a racing, pounding, or irregular heartbeat may occur because of abnormal heart rhythms.
- Dizziness: Reduced cardiac output or abnormal rhythms may cause lightheadedness, particularly during activity.
- Fainting: Episodes of unexplained fainting may occur and require medical evaluation, especially in people with known HCM.
- Fatigue: Reduced ability of the heart to fill or pump efficiently can lead to tiredness and reduced exercise tolerance.
Causes and Risk Factors of Hypertrophic Cardiomyopathy
Causes
- Inherited Genetic Changes: Most familial HCM is linked to genetic variants that affect proteins involved in heart muscle contraction.
- Spontaneous Genetic Changes: Some patients develop HCM without a known family history.
- Unexplained Causes: In some individuals, no specific genetic or other cause is identified.
- Associated Conditions: Some heart-muscle disorders can produce thickening that resembles HCM and require careful evaluation to distinguish them from true HCM.
Risk Factors
- Family History: Having a first-degree relative with HCM or unexplained sudden cardiac death can increase risk.
- Genetic Predisposition: Inherited disease-causing variants can increase susceptibility.
- Age: HCM can become apparent during childhood, adolescence, adulthood, or later life.
- Previous Abnormal Cardiac Findings: Unexplained heart-muscle thickening or abnormal ECG findings may prompt further assessment.
- Family History of Sudden Cardiac Death: This may be an important factor in individual risk assessment.
Latest Research and Technologies in the Treatment of Hypertrophic Cardiomyopathy in India
- Recent advances in HCM care include cardiac MRI for detailed assessment of heart muscle thickness and scar tissue, advanced echocardiography for evaluating blood-flow obstruction, and genetic testing for selected patients and families. Newer cardiac myosin inhibitors, such as mavacamten, provide a targeted treatment option for selected adults with symptomatic obstructive HCM. Advanced risk assessment also helps identify patients who may benefit from ICDs, while specialised centres can offer septal reduction procedures, including surgical myectomy and selected catheter-based approaches.
Treatment options for Hypertrophic Cardiomyopathy
Septal Myectomy: This open-heart surgical procedure (Morrow procedure) remains the gold-standard intervention to physically excise a portion of the hypertrophied septum and relieve left ventricular outflow tract (LVOT) obstruction.
Alcohol Septal Ablation: A minimally invasive, catheter-based alternative to surgery where pure alcohol is injected into a septal branch artery to induce a localised controlled infarction, thinning the muscle to reduce obstruction.
Implantable Cardioverter-Defibrillator (ICD) : Because HCM is a leading cause of sudden cardiac death in young people and athletes due to ventricular arrhythmias, primary or secondary prevention with an ICD is an essential treatment pillar.
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Heart Transplantation : For the small percentage of HCM patients who progress to end-stage, non-obstructive "burnt-out" heart failure, an orthotopic heart transplant is the final definitive option
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- Clinical assessment:
- Medical and Family History: Assessment of symptoms, exercise tolerance, previous fainting, family history of HCM, and sudden cardiac death.
- Physical Examination: Evaluation for heart murmurs, abnormal heart sounds, blood pressure changes, and signs of heart failure.
- Electrocardiogram (ECG): May identify abnormal electrical patterns associated with HCM.
- Holter or Ambulatory ECG Monitoring: Detects intermittent arrhythmias that may not appear on a standard ECG.
- Exercise Testing: May assess exercise capacity, blood pressure response, symptoms, and exercise-related obstruction.
- Genetic Testing: May be offered to selected patients to identify disease-causing variants and support family screening.
- Imaging Tests:
- Echocardiography: The main imaging test used to assess heart-muscle thickness, heart function, valve movement, and obstruction.
- Cardiac MRI: Provides detailed images of heart structure and can identify myocardial scar and other tissue characteristics.
- Stress Echocardiography: May reveal obstruction or abnormalities that become apparent during exercise.
- Chest X-ray: May help evaluate heart size and associated lung findings when clinically indicated.
- Cardiac CT: Consider in selected patients when additional anatomical information is needed.
MediRehab (a chain of Rehab centres, part of MediGence) provides comprehensive rehabilitation services designed to support Hypertrophic Cardiomyopathy patients in India. These services include:
- Individualised Exercise: Appropriate physical activity can be encouraged according to symptoms, disease severity, and specialist advice.
- Cardiac Rehabilitation: Selected patients may benefit from structured, supervised rehabilitation.
- Physical Conditioning: Gradual activity can help maintain functional capacity while avoiding inappropriate exertion.
- Weight Management: Maintaining a healthy weight can reduce additional cardiovascular strain.
- Long-Term Follow-Up: Regular cardiology assessments help monitor symptoms, heart function, rhythm, and response to treatment.
- Select medicines based on symptoms, obstruction, heart rhythm, and overall heart function. Beta-blockers and certain calcium-channel blockers may help reduce symptoms and improve ventricular filling. Selected patients with obstructive HCM may receive cardiac myosin inhibitors, while antiarrhythmic or anticoagulant medicines may be prescribed when clinically indicated. Treatment should be supervised by a cardiologist experienced in HCM.
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Hospitals for Hypertrophic Cardiomyopathy in India
The Madras Institute of Orthopedics and Traumatology
Chennai, India
MIOT started its journey with only 70 beds and focusing on Orthopedics and Trauma care. However, we grew into a multi-specialty hospital with time. MIOT is now a 1000-bedded hospital and can offer an extensive range of services across 63 specialties. The state of art laboratory of our hospital is ranked 8th internationally. We have 21 super-specialty operation theaters equipped with cutting-edge technology to help our doctors with complex procedures.
We take great care to make our patient rooms comfortable enough. The patient rooms get plenty of fresh air as well as natural light. The soothing views from the rooms do not let the patients feel cut off from the outside world. We use separate entrances for emergency patients, out-patients, in-patients, and their attendants. We put our patients’ safety first which is why we use a superior air system to ensure a near-zero infection healthy environment.
Apart from that, MIOT’s 24 hours blood bank provides all kinds of blood work related services which include blood collection to component separation. This state-of-art blood bank alone handles more than 30,000 units of blood over the course of a year. Every month around 600 blood transfusions are managed by this blood bank.
MIOT’s SIGNA Pioneer 3T MRI machine is made with noise reduction technology. This silent MRI machine can deliver superior quality neuroimages without wasting any time. The department of Radiology and Imaging Sciences can give tough competition to any international hospital with its advanced technology and accuracy.
The PET CT service at MIOT International is the first of its kind in South India enabling better and more accurate diagnosis than earlier. The superior diagnosis is also possible for the two digital cath labs at MIOT Heart Revive center.
We also have a physiotherapy team where a team of highly efficient physiotherapists deals with the mobility and functional disability issues of our patients. They listen to the patients carefully to identify the root of the pain and use therapeutic exercises to reduce their pain.
The CCU of MIOT is something to be proud of. The specially-trained staff of this unit is dedicated to ensuring top-quality medical support to serious patients. This unit along with the MIOT International Laboratory is the backbone of our facility.
Furthermore, what makes MIOT unique is our Telemedicine service. In the new normal, we are trying everything to reach our patients. Our one of its kind Telemedicine service connects our patients to our 250 full-time doctors over email, phone, chat and video consultations.
Manipal Hospital, Ghaziabad
Ghaziabad, India
Founded in 2010, Manipal Hospital-Ghaziabad (formerly Columbia Asia Hospital) is a well-known multispecialty hospital accredited by the National Accreditation Board for Hospitals and Healthcare Providers (NABH). With 100 beds, the hospital is committed to providing effective and reasonably priced healthcare in a clean and safe setting. The hospital has several departments that are known for their expertise, including Orthopaedics, Internal Medicine, Gastroenterology, Plastic Surgery, Obstetrics and Gynecology, ENT, and more. Due to this recognition, the hospital is now regarded as one of the best medical establishments in the Ghaziabad area.
Seven Hills Hospital
Mumbai, India
Seven Hills Hospital located in Mumbai, India is accredited by JCI, NABH, NABL. Also listed below are some of the most prominent infrastructural details:
- It is spread over an area of 17 acres.
- There is also an academic institute with research facilities.
- SevenHills Hospital has excellent diagnostic services including a laboratory and a provision for various tests.
- Given that their are specific departments for various kinds of diagnostsic. Tests like PET Scan, MRI, CT scan and biopsies are completed regularly.
- Biochemistry, Hematology, Microbiology are some of the important diagnostic departments.
- Endoscopies as well as non-invasive procedures are done through their respective departments.
- Day care specialty services are available for those kinds of requirements.
- Health Check up packages are also present as are the collaborations with many insurance organisations.
- There are professionally managed in-patient and out-patient facilities.
- There are more than 30 super specialties in Seven Hills Hospital Mumbai.
- There are also Centres of Excellence in Cardiac Care, Neurosciences, Bone & Joint Care, Cancer Care, Nephrology and Cosmetic Dermatology.
- International patient care services are also implemented for the best assistance to overseas patients.
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Why Choose India for Hypertrophic Cardiomyopathy Treatment?
- Experienced Cardiac Specialists: India has cardiologists, electrophysiologists, cardiac surgeons, and specialists experienced in managing complex heart-muscle disorders.
- Advanced Cardiac Imaging: Major centres may offer advanced echocardiography, cardiac MRI, CT, and ambulatory rhythm monitoring.
- Specialised HCM Management: Appropriate patients may have access to medicines, cardiac myosin inhibitors, septal myectomy, alcohol septal ablation, and ICD implantation.
- Advanced Electrophysiology Services: Specialist centres can evaluate and manage arrhythmias and assess the need for ICDs.
- Multidisciplinary Care: Cardiology, electrophysiology, cardiac surgery, genetics, imaging, rehabilitation, and other specialists can collaborate for complex cases.
- Genetic Evaluation: Selected patients and families can undergo genetic counselling and testing where appropriate.
- Personalised Treatment: Management is tailored according to symptoms, obstruction, heart function, arrhythmia risk, and genetic or family history.
- International Patient Support: Many major Indian hospitals offer assistance with appointments, treatment coordination, accommodation, and follow-up for international patients.