In an article published in the European Heart Journal, Drs. Barry Maron and Ankur Kalra discuss challenges in managing hypertrophic cardiomyopathy (HCM) patients in India, and propose a heirarchical model for establishing HCM Centers of Excellence in India.
Kalra Hospital SRCNC Pvt. Ltd. will be establishing India's first HCM Center of Excellence, and unveiling its name and logo on the World Heart Day in September 2014 at the Le Meridien in New Delhi, India.
From the European Heart Journal:
Hypertrophic cardiomyopathy can now be regarded as a global disease, recognized in >50 countries, with patients exposed to the intricacies of a wide variety of healthcare systems. This includes countries with developing economies and healthcare which involves many other medical and non-medical priorities that dominate their resources and logistics, and inadvertently direct attention from less common complex genetic heart diseases (such as HCM). In this respect, India can be considered a model of the medical dilemma in which important diseases such as HCM are in danger of being over-run and obscured by the mass of patients with valvular and atherosclerotic CAD, at a time when cardiovascular diseases have become the number one cause of death in the country.
Indeed, India is currently the second most populous country in the world, with 1.23 billion people, soon to surpass China in this regard. This fact alone poses obvious obstacles to the delivery of specialized healthcare services, and particularly for less common diseases. India has 4000 cardiologists, but the ratio to cardiac patients is unfavourable, with an estimated 9.2 million productive years of life lost to cardiovascular diseases in 2000, a number that is expected to rise to 18 million by 2030 (10 times the rate in the USA). This point underscores the overwhelming burden on practitioners in terms of time, energy, and resources legitimately devoted to a variety of cardiac problems, other than those posed by diseases such as HCM. Inevitably, patients with HCM become ‘lost’ within general cardiology practice.
In addition, there is the practical challenge faced by cardiologists and other practitioners in keeping abreast of advances in diagnosis and management for such a heterogeneous disease distinctly different from CAD, and which occupies an essentially separate literature. This is a particular concern considering the heavy workload and long week to which practising Indian cardiologists are routinely exposed. Indeed, in HCM, there is seemingly ever-changing information (including formal practice guidelines) that can often generate controversy, even among the relatively small group of investigators dedicated to this disease.