The Centre for Cardiac Risk in Younger Persons (CRYP) opened in a dedicated clinic in Tallaght University Hospital in November 2008. CRYP was developed as an inherited cardiac conditions service, and despite the name, there is no upper age limit for our patients, we see anyone with, or possible at risk of having an inherited cardiac condition.
Patients are usually referred either by their GP or another Consultant because they may have a cardiac condition themselves, or there is a history in the family which suggests there may be an inherited condition in the family (for example, a family who is affected by sudden cardiac death in a young person, or a close relative has been diagnosed with a heart muscle or electrical problem that can be hereditary).
Conditions that we test for and manage include cardiomyopathy (heart muscle conditions) including Hypertrophic Cardiomyopathy (HCM or HOCM or even HOKUM) where the heart muscle grows thicker than normal, Dilated Cardiomyopathy (DCM) where the heart is enlarged and doesn’t pump as well as it should, or Arrhythmogenic Cardiomyopathy (previously known as ARVC or ARVD) where people develop scarring in the heart which can cause rhythm problems or pump function problems. We also test for electrical conditions such as Long QT syndrome (previously known as Romano-Ward Syndrome), Brugada Syndrome, and Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT). These are all conditions where a fault in the electrical channels in the cells in the heart can cause an abnormal pattern on the ECG (see below), and can cause rhythm abnormalities (such as palpitations, blackouts or sudden death).
We also see some patients and families with premature heart attacks (due to coronary disease, also known as hardening of the arteries, or blockages in the blood vessels). This can be due to genetic problems with cholesterol (familial hyperlipidaemia), where people can have a genetic problem that means that their cholesterol levels are extremely high (maybe over 10, where normal is usually less than five), and this can cause people to have heart attacks in their 30’s and 40’s, even if they don’t smoke or have any other risk factors.
We also see patients where heart problems can occur as part of a genetic syndrome affecting other parts of the body, especially the nervous system. These would include Freidreich’s Ataxia, Muscular Dystrophies and Myotonic Dystrophies. Where possible we carry out cardiac investigations for these patients when they attend other services as part of a multi-disciplinary team.
While most of our patients are one years of age and older, we also run a Family Clinic with our Paediatric Cardiology Colleagues (Dr. David Coleman and Dr. Terry Prendiville) where children of all ages can be seen together with their parents and older family members.
A number of tests are performed on the day, which include an ECG, Echo, Exercise test (or Stress Test) and a Holter monitor (see below where each is described in more detail).
Further testing including genetic tests, MRIs or medication tests can be arranged by the Consultant if required. Each patient is also assessed by a Doctor and test results are given on the same day where possible.
The Centre is currently being funded almost entirely by direct private donations or donations to the charity Cardiac Risk in the Young (CRY – Ireland).The Centre has also been generously supported by the Adelaide Society, the Meath Foundation, The National Children’s Hospital Foundation and the Tallaght University Hospital Coffee Shop Volunteers.
Full-time staff at the Centre include the Cardiologist, a Clinical Nurse Specialist, an Administrator and one or two Cardiac Technicians who will perform your tests and answer any questions you may have on the day.
CRY-Ireland provide counselling services where appropriate (both for bereavement support, or helping to adjust to being diagnosed with a heart condition). This can be arranged by contacting the charity (www.cry.ie for further details), or you can discuss with the staff on the day you attend for your appointment.
Access to the service is by referral from another doctor (GP or Consultant usually). There is no charge for the services provided and we accept referrals from anywhere in the country. Letters of referral can be sent to Dr. Deirdre Ward, care of The Cardiac Department in Tallaght University Hospital for the attention of Dr. Ward. We can also be contacted at 01 414 3058 or by email at CDYPclinic@tuh.ie