Hypertrophic cardiomyopathy in the developing world: focus on India

Atherosclerotic coronary artery disease (CAD) and peripheral arterial disease are global public health and socio-economic issues associated with important treatment advances that affect millions of lives every year. Hypertrophic cardiomyopathy (HCM), although less common, has also become a treatable form of heart disease with demonstrable reduction in mortality and increased survival,1–4 entering a modern era with the inception of high resolution imaging, widely available genetic testing and counselling, implantable cardioverter defibrillators (ICDs), heart transplant, surgical myectomy, and alcohol septal ablation.4 Much has changed for HCM patients who historically have too often been considered ‘interesting’ or as having an ‘exotic’ disease, making them ideal subjects for research studies, but with prognosis considered largely grim. Effective treatment advances, and recognition that many (if not most) patients affected by HCM may not require major therapeutic interventions, permits a realistic aspiration for normal or extended longevity and good quality of life.1 However, most interest in HCM has resided disproportionately in North America, Europe, portions of Asia (largely Japan), Israel, and Australia. Hence, it is patients in those countries who benefit most from the technological and management advances applicable to HCM.