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
BGS Gleneagles Global Hospitals
Bangalore, India
Gleneagles BGS Hospital, Kengeri, is a leading healthcare centre in Bengaluru, committed to delivering compassionate, patient-focused care locally and globally. The hospital houses 15 specialised departments with over 30 medical and surgical specialities, supported by 450 beds, advanced emergency services, imaging, laboratory, and transfusion facilities.
It is renowned for pioneering initiatives such as South India’s first 5G-enabled ambulance and Karnataka’s largest Multi-Organ Transplant Program. Recognised among India’s top paediatric cranio-maxillofacial centres, it is also the first in Karnataka to receive the AHPI Award 2024 for “Excellence in Nursing Practices” consecutively.
Indraprastha Apollo Hospital
Delhi, India
Indraprastha Apollo Hospital is known for delivering treatment to over 200,000 patients every year; 10,000 of which are generally medical tourists. The efficient team of doctors has the record of 99.6 percent success rate. Indraprastha Apollo Hospital deals in treatment of over 50 specialities.
Let’s see some of the features of the infrastructure:
- Spread over 15 acres, the hospital has 710 beds.
- 6 beds dedicated to bone marrow transplant units with very strict infection control practices.
- 64-Slice Scan coupled with data acquisition which provides highest temporal resolution
- One of the hospitals to be using Da Vinci Robotics Surgery System
- In South Asia, the Spect-CT and Pet-CT got their first installation at Indraprastha Apollo Hospital in India
- Technologies such as PET- MR, BrainLab Navigation System, PET-CT, Portable CT Scanner, Tilting MRI, NovalisTx, Cobalt based HDR Brachytherapy, Hyperbaric Chamber, DSA Lab, Fibroscan, 3 Tesla MRI, Endosonography, 128 Slice CT scanner are all installed at the hospital.
- The Cancer Institute at Indraprastha Apollo is equipped with a highly advanced Radiation Oncology Center with ClinaciX, NovalisTx, and HDR-Brachytherapy.
- It is equipped with the largest Sleep Lab in Asia, & has one of the largest Dialysis Units in India.
- A large number of ICU beds than any other Private Hospitals in India.
- WIFI is accessible across the whole campus.
Manipal Hospital, Yeshwantpur
Bangalore, India
Manipal Hospital, Yeshwantpur located in Bengaluru, India is accredited by NABH. Also listed below are some of the most prominent infrastructural details:
- Super-specialty healthcare facility
- Started operations in July 2008
- Video consultations with specialists
- Various health checkup packages available
- Technological applications in healthcare and healthcare delivery
- Many ancillar services available like
- ICU, NICU
- Physiotherapy
- Referral lab
- Teleradiology / telemedicine
- Pharmacy
- Imaging facilities
- Rehabilitation services, 24 hour emergency services, operating theatre, ambulatory and daycare, cafeteria, and many kinds of patient accomodation.
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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.