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Hypertrophic Cardiomyopathy


image    To make an appointment, please call (212) 305-6936.


ColumbiaDoctors Cardiology is at the forefront of care and treatment of patients with hypertrophic cardiomyopathy and is pioneering advances in the field through multicenter research studies.

Hypertrophic cardiomyopathy (HCM) is a disease in which the heart muscle becomes abnormally thick, making it harder to pump blood. Often, only one part of the heart is thicker than the other parts. HCM affects people of all ages and often goes undiagnosed. Many people have few or no symptoms and can lead normal lives; others experience symptoms that can include chest pains, shortness of breath, arrhythmias (abnormal heart rhythms) or syncope (fainting). In some cases HCM can be life threatening.

Our team offers multidisciplinary care for patients with HCM that addresses symptoms, risk of arrhythmias, genetic and family counseling, and therapeutic interventions. By combining specialists from pediatrics, cardiac imaging, genetics, interventional cardiology, and cardiac surgery, we have formed a team that can comprehensively provide help to all patients with HCM and their families. Our team includes experts who are at the forefront of advances in management in the field and are participating in several multicenter research studies.

Learn more about our surgical partners at the HCM Center.

Comprehensive Care For Patients and Families Throughout Their Lives

Diagnostic Testing

Dedicated sonographers at the HCM Center perform every patient's echocardiogram, which is the test that forms the basis of many clinical decisions related to HCM. We also perform stress echocardiography on most patients because the dynamic nature of the condition means that many abnormalities are present only during activity. We have access to the latest in 3D imaging, including advanced cardiac MRI with T1 mapping, and quantification of late gadolinium enhancement which allows us to diagnose HCM and other related conditions such as amyloidosis and Fabry’s disease and to risk-stratify individuals for dangerous arrhythmias. We use gated cardiac CT with 3D printing services to guide interventions such as surgical myectomy and alcohol septal ablation and to assess for coronary artery disease in patients with chest pain.

Medical Management

Many symptomatic patients will be treated with a beta-blocker or calcium channel blocker. These medications form the cornerstone of medical management when there is significant left ventricular outflow tract obstruction. Some patients may benefit from the addition of disopyramide if they continue to remain symptomatic, though there are a number of possible side effects related to this medication and patients may need to be admitted to hospital to commence therapy. Our team has extensive experience with the use of these agents and newer therapies which are currently being trialed.

Genetic Testing

HCM is the most common genetic cardiac condition, affecting between 1/200 and 1/500 of the population. Consequently, genetic testing for this condition has advanced rapidly and is now available to provide a specific answer to the question of how the condition was caused in many HCM patients. Columbia offers access to genetic testing for all our HCM patients and we have some of the best cardiac geneticists and genetic counselling services in the tristate area.

Cardiac Catheterization

An important component of HCM is understanding the severity of the problem and determining what therapies may be available. Cardiac catheterization is performed by physicians in our HCM program to assess the severity of outflow tract obstruction, visualize coronary artery anatomy, and perform alcohol septal ablation procedures. This procedure, where a small amount of alcohol is injected into one of the coronary arteries, can be a noninvasive alternative to myectomy surgery for patients with obstruction.

AICD Implantation

Our electrophysiology team is expert in implanting defibrillators both transvenous and subcutaneous. The availability of both these options is beneficial given the large number of younger patients with the condition. Specific expertise with the types of arrhythmias suffered by those with HCM (like atrial fibrillation and ventricular tachycardia) can be addressed with our team who sees many patients like you.

Surgical Myectomy

We are a high volume center for septal myectomy and our HCM surgeon, Dr Hiroo Takayama, specializes in this procedure. He has perfected the technique of extended septal myectomy for patients with more extensive HCM, and we have excellent outcomes. If you are a candidate for septal myectomy, your care will be provided by a member of the HCM team in the ICU and stepdown area postoperatively. Follow-up will be with your local cardiologist or with your HCM team member for 1-2 weeks after discharge.

Pregnancy and Prepregnancy Counseling

Our cardiologists have extensive experience with managing heart conditions throughout pregnancy. Most women with HCM can get pregnant, successfully carry through to term, and have a normal delivery with an excellent outcome. We seamlessly interact with your own obstetrician or with our high-risk obstetrics team here at Columbia to ensure that you feel safe and confident of the best outcomes for you and your baby. We also have the ability to refer you to gynecologists with expertise in the management of contraception and fertility management in women with heart conditions.

Cardiac Transplant Assessment

Our HCM team contains experts in heart failure and cardiac transplantation, both on the surgical and medical sides. A very small number of HCM patients require cardiac transplantation, and we have one of the largest programs for managing heart transplant in HCM patients in North America.

3D Reconstruction of the Heart in Hypertrophic Cardiomyopathy

This 3D reconstruction of the heart can be printed out and used by our cardiologists and surgeons to better plan surgical treatment. This is a view looking into the left ventricle; the mitral valve appears in orange and the planned myectomy in green, with the remained of the heart in white.

HCM

 

Make an Appointment

161 Fort Washington Avenue
6th floor, Suite 627
New York, NY, 10032

(212) 305-6936
(212) 305-0490 (fax)

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