Hypertrophic Obstructive Cardio Myopathy (HOCM)

Hypertrophic Obstructive Cardio Myopathy is a rare genetic disorder affecting heart muscles usually characterised by

1. Hypertrophy (Thick & Stiffness) of the heart muscles.

2. Out-flow tract obstruction of Left ventricle due to septal Hypertrophy. - LVOT Obstruction

3. Mitral Regurgitation (MR) due to a Venturi effect of LVOT obstruction.

HOCM can lead to serious health issues such as heart failure, syncope and is  one of the leading cause of Sudden Cardiac Death (SCD).

How do HOCM Patients Present?

• Chest pain (Especially during activity)

• Breathlessness

• Syncope (fainting),

• Arrhythmia (Irregular heart rhythm)

• Palpitation

• Rarely heart failure.

Diagnosis For HOCM:

Echocardiogram is a basic diagnosis tool. After seeing the thickness of heart muscles, We usually perform a MRI scan to look into the degree of muscle hypertrophy (Thickness & Stiffness) with the level of fibrosis of the heart muscle and quantify the Mitral Regurgitation as well

Treatment Plan:

• The initial management of HOCM patients is with drugs like Beta Blockers, Calcium Channel Blockers and Anti-arrythmics.

• Surgical Intervention :

Extended Septal Myectomy gives excellent results.

The out come of this procedure is usually very good and the prognosis after a successful surgery is quite comparable to normal population.

Even though there is significant Mitral Regurgitation in patients with HOCM, we usually do not replace the Mitral Valve. An adequate septal muscle resection usually resolves the MR and the native Mitral Valve can be preserved in majority of cases.

Though the procedure is technically difficult and not performed in many centres, in expertise hands the results are phenomenal.

The team led by Dr Anbarasu Mohanraj as special expertise and experience  in this procedure and has possibly done the maximum number of such surgeries in this part of the country.

• Alcoholic Septal Ablation (ASA) is an alternative, but is usually reserved only for elderly patients who cannot withstand a cardiac surgical procedure.

Some patients may need a AICD - Automatic Implantable Cardio De- fibrillator to prevent sudden cardiac death.

Further plan:

As this disorder is genetically carried and can run in the families, the first degree relatives of the patients with HOCM need to undergo a ECHO screening to rule out the presence of HOCM in these blood related siblings and children.