Hypertrophic Cardiomyopathy (HCM) Expertise

Clinical Services: Cardiology
Upper East Side
520 East 70th Street, Starr Pavilion, 4th Floor
New York, NY 10021
Call
(646) 962-2243

Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disease, affecting 1 out of 200 people. HCM affects all age groups, from newborns to the elderly. 

HCM is characterized by abnormal thickening of the heart muscle, which most typically occurs unevenly in the left ventricle (the main pumping chamber). This thickening makes it harder for the heart to pump blood properly. Thickening of the outflow region of the left ventricle can cause narrowing (obstruction), which may also lead dysfunction of the mitral valve and cause blood to leak backward during the heart’s contraction.  

HCM can cause: 
●  Shortness of breath with activity
●  Chest discomfort 
●  Dizziness 
●  Heart rhythm abnormalities, including atrial fibrillation or ventricular tachycardia 
●  Heart valve infection (endocarditis) 

Care at Weill Cornell Medicine HCM Program

HCM should be evaluated and treated by an experienced cardiologist. At the Weill Cornell Medicine HCM Program, our physicians specialize in diagnosing and treating this condition—as well as helping our patients live the active, full life they want. 

Our cardiologists understand that every person with HCM is affected differently. That is why we take the time to assess you individually and tailor a treatment plan for your specific needs. 

The cardiologists at the HCM Center have developed novel techniques for diagnosing and treating HCM, including the use of 3D printing to plan interventions and robotic surgery to perform minimally invasive complex heart operations. 

Your treatment plan will be developed by our expert cardiologists, as well as with the help of specialists in genetics, cardiac imaging, electrophysiology, cardiac catheterization, and heart surgery. We can provide advice regarding work activity, pregnancy, participation in sports, and risks to your family members. 

We have several ongoing research projects in which we welcome participation if you meet the necessary criteria. 

Areas of Expertise at the HCM Center 

Echocardiography: Echo (ultrasound of the heart) is the cornerstone of diagnostic imaging for HCM. The echo program at Weill Cornell Medicine is internationally recognized for research in inheritable cardiac conditions. 

We utilize stress echocardiography on most patients because with HCM obstruction, abnormalities are present only during activity. 3D echo and contrast echocardiography can be used to guide interventional treatments.

Advanced imaging: The nationally renowned cardiac imaging program at Weill Cornell Medicine performs cardiac MRI and CT scans using the latest scanners and sequences. 

MRI scans can be used to diagnose HCM and can also be useful in determining the risk of dangerous arrhythmias and need for AICD. Gated cardiac CT 3D printing is used to guide interventions such as surgical myectomy and alcohol septal ablation and to assess for coronary artery disease in patients with chest pain.

Genetics: Rapid improvements in technology and efficiency now make genetic testing for HCM readily available. This can be used to confirm the underlying genetic mutation that caused HCM. This means that it is simple for you and your family members to receive screening.

Genetic testing and counseling services are available at the Weill Cornell Medicine HCM program in conjunction with the Medical Genetics program.

Medical treatment: Our cardiologists have extensive experience in the use of medical therapies for HCM. These medications form the cornerstone of medical management when there is significant left ventricular outflow tract obstruction. 

We tailor a medication plan to address your specific symptoms and help you live the life you want. 

Cardiac catheterization: The interventional cardiology program at Weill Cornell Medicine is nationally recognized for structural and complex interventions. 

Catheterization can be used to determine the pressure levels in the heart, assessing for coronary blockages, and is used to guide non-invasive intervention such as alcohol ablation. 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.

Electrophysiology: HCM carries a risk of dangerous heart rhythms, which can cause collapse and even sudden death. For those at risk, a defibrillator may be recommended depending on their risk level. Our electrophysiology team can implant a defibrillator under the skin (subcutaneously) in addition to the more traditional transvenous route. 

Surgical myectomy: We perform many septal myectomy procedures. This procedure—performed through several keyhole incisions—removes a piece of thickened heart muscle that causes obstruction. Most patients can expect to be discharged four to five days after surgery and be back to their regular activities after two to three weeks.

Gynecologic and pregnancy counseling: A heart condition must be evaluated when considering contraception and pregnancy. Our cardiologists have extensive experience with these issues and can take advantage of the robust Maternal-Fetal Medicine Program at Weill Cornell Medicine. Most women with HCM can safely become pregnant and successfully deliver a baby with minimal risk. 

Heart failure assessment: Our HCM team includes experts in heart failure, pulmonary hypertension, mechanical support devices, and cardiac transplantation. 

A small number of HCM patients require advanced therapies, such as mechanical support, which can be performed at Weill Cornell Medical Center, and cardiac transplantation, which we can facilitate at our sister hospital, NYP/Columbia, if needed.

Request an Appointment 

To schedule an appointment, please call (646) 962-2243.

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Maria Karas, M.D.
Cardiovascular Disease  
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