Hypertrophic Cardiomyopathy: Advanced Treatment Now Available in Latvia

Latvia Advances Hypertrophic Cardiomyopathy Treatment, Becoming Regional Center of Excellence

The Pauls Stradins Clinical University Hospital (PSKUS) in Latvia is rapidly developing into a leading center for the surgical treatment of hypertrophic cardiomyopathy (HCM), a genetic heart condition that can range from a long, asymptomatic course to sudden cardiac death or severe progressive heart failure. The hospital is expanding its capabilities to treat even complex cases, offering patients access to cutting-edge surgical techniques.

According to PSKUS, approximately 70% of patients with HCM develop left ventricular outflow tract obstruction – a narrowing of the heart’s exit pathway. Common symptoms include shortness of breath during exertion or at rest, chest pain, palpitations, and fainting spells. When medication proves ineffective, surgical treatment, specifically septal myectomy – the removal of a portion of the thickened heart muscle – is recommended. This procedure is described as highly effective with a low risk of mortality and complications.

PSKUS reports that through international collaboration and knowledge exchange, Latvia now offers the most modern surgical treatment for this condition, even in anatomically challenging cases. The hospital is actively building an excellence center for HCM surgical treatment within Latvia and has joined a select group of specialized centers in Europe that treat patients with complex forms of the disease.

Professor Stradins, head of the Heart Surgery Center at Stradins Hospital, emphasized the importance of international cooperation in the center’s development. He explained that surgical treatment for hypertrophic obstructive cardiomyopathy requires a high degree of specialization and experience. “Regularly performing complex operations and collaborating with leading European specialists allows us to purposefully develop this field and provide patients with treatment according to the highest international standards,” he stated.

HCM is characterized by a thickening of the heart muscle, which can obstruct blood flow and lead to a variety of symptoms. The condition is often inherited, following an autosomal dominant pattern, as noted in recent research. Diagnosis typically involves echocardiography, cardiac magnetic resonance imaging, and genetic testing.

While the overall prognosis for patients with HCM is generally favorable with available treatments, the disease carries a significant health burden. Advances in both pharmacological and invasive therapies are transforming the management of the condition. Current treatment options include medical therapy to manage symptoms, as well as surgical interventions like septal myectomy and alcohol septal ablation (ASA), a less invasive procedure that uses alcohol to reduce the thickness of the heart muscle.

Emerging therapies, including novel pharmacological agents and gene editing techniques, are also being investigated as potential future treatment modalities. Percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) is another technique being explored, though its role remains under evaluation. The BMJ notes that long-established medical and surgical treatment options exist for both obstructive and non-obstructive forms of the disease.

The development of PSKUS as a regional center of excellence offers hope for improved outcomes for patients with HCM, providing access to advanced surgical techniques and a collaborative network of international experts. The hospital’s commitment to international collaboration and continuous improvement positions it as a key player in the ongoing advancement of HCM treatment.