If you are diagnosed with hypertrophic cardiomyopathy (HCM), you want the best care possible. To best serve this goal, The Valley Hospital’s Hypertrophic Cardiomyopathy Program proudly offers:
- High-quality assessment using state-of-the-art resources to manage your condition
- A treatment plan based on the latest guidelines, tailored to meet your needs
- Long-term management in partnership with you, your physician, and other experts in the field
The Valley Approach to Hypertrophic Cardiomyopathy
- Our Hypertrophic Cardiomyopathy Program employs a team-based approach to HCM management and treatment. Our team includes cardiac imaging specialists, heart failure specialists, interventional cardiologists, electrophysiologists, and cardiac surgeons.
- Our multidisciplinary team regularly reviews challenging HCM cases and develops appropriate, individualized management for each patient.
Diagnosing Hypertrophic Cardiomyopathy
A diagnosis of HCM begins with an individual assessment to evaluate your risk of sudden cardiac death and heart failure; a discussion of the benefits of genetic counseling and testing; family screening; and determining the proper activity level for you. Using advanced technologies, we can accurately make or confirm a diagnosis of HCM and evaluate for any other HCM-mimicking diseases that have a different management and prognosis.
Hypertrophic cardiomyopathy can be diagnosed in a variety of ways, including:
- Electrocardiogram (ECG or EKG) - Usually the first test to suggest HCM
- Echocardiogram evaluation for asymmetric thickening of the heart and blood flow obstruction
- Cardiac MRI - the gold standard for HCM diagnosis - which evaluates the amount of scarring in the heart muscle
- Cardiac computed tomography (CT) – Assists in accurately detecting the anatomy of patients, helpful in patients for whom surgery or intervention may be recommended
- Exercise stress echocardiogram
Hypertrophic Cardiomyopathy Treatment Options
Not everybody is the same! Every patient in the Hypertrophic Cardiomyopathy Program receives an individualized treatment plan tailored to meet their needs. Medical management, implantable devices, lifestyle changes, or interventions may be recommended to manage and control this condition. These treatments help improve patients' symptoms and their risk of sudden cardiac death.
Medical Management
Hypertrophic cardiomyopathy with heart failure symptoms, both obstructive and non-obstructive, is first managed using medication:
- Beta-blockers help decrease HCM symptoms by blocking the hormone adrenaline. This can help the heart to fill properly with blood and optimize its heart rate and contraction.
- Calcium channel blockers work by slowing the buildup of calcium in the cardiac cells. This may lead to a decrease in the strength of contractility of the heart and a decrease in the heart rate.
Stronger medications might be required for patients with obstructive cardiomyopathy:
- Antiarrhythmic medications are used to treat patients with obstructive HCM. This medication decreases and delays the contraction of the heart muscle, leading to a decrease of left ventricular outflow obstruction.
- Cardiac myosin inhibitors directly inhibits the muscle fibrils that decreases the heart muscle contraction, with a decrease in left ventricular outflow obstruction.
Implantable Devices
Patients with HCM who, after evaluation, are considered at high risk for sudden cardiac death will be recommended for an implantable defibrillator-cardioverter (ICD). This device monitors the heart's rhythm and rate and can deliver an electric shock to correct a dangerous and erratic heartbeat.
Lifestyle Changes
If you have HCM, your physician may recommend lifestyle modifications such as diet and exercise, monitoring your blood pressure, managing stress levels, quitting smoking, or limiting your alcohol intake. The level of exercise will be individualized.
Genetic Counseling and Testing
It is important to understand if other family members could be affected and for family planning purposes. A large panel of genes involved in the HCM can be tested.
Interventions
- Surgical myectomy: If you have obstructive HCM, and medication proved to be ineffective, you may be recommended for a surgical intervention. Surgical myectomy is heart surgery that removes a portion of the abnormally thickened heart muscle at the septum between the ventricles. This procedure increases the opening of the heart’s outflow area to relieve the obstruction and allow proper blood flow.
- Alcohol septal ablation: If you are of advanced age or have additional underlying conditions, alcohol septal ablation may be used to decrease the thickness of the septum. During this minimally invasive procedure, alcohol is injected into one of the heart’s arteries through a catheter and creates a controlled myocardial infarction to shrink the enlarged tissue.
If heart function deteriorates and medication, devices, and/or surgery fail to improve the function or the symptoms, a heart transplant may be required.
Why Choose Valley for Hypertrophic Cardiomyopathy Care?
- A team dedicated to you: At Valley, you’ll get team-based care from cardiologists, electrophysiologists, heart surgeons, interventional cardiologists, heart failure nurses, and others who meet regularly and evaluate as a team the optimal management for you and your family.
- Cleveland Clinic alliance: Our alliance with Cleveland Clinic’s nationally ranked heart program allows us to consult with the nation’s very best for the most complex cases.
- Advanced screening technologies: Valley partners with Viz.ai, an artificial intelligence program, that can help to effectively screen for hypertrophic cardiomyopathy based on ECG.
- Expertise in diagnosing and treating HCM: Many patients come to us after a long diagnostic journey that has not provided answers. Our team’s expertise in cardiac imaging, combined with highly detailed diagnostic technology, allows us to make complicated diagnoses with precision. Personalized medical or interventional management will help improve your symptoms.
- A dedication to research: The Valley HCM team is involved in the latest novel research to provide patients with the newest management strategies and technologies for HCM management.
- Access to the latest heart procedures: Heart surgery and interventional cardiology procedures may be required to treat certain symptoms of HCM. We use innovative, specific, and highly accurate imaging to guide any invasive procedures.
