Overview
Left ventricular hypertrophy (LVH) is a condition characterized by thickening of the walls of the left ventricle, which is the heart's main pumping chamber. This thickening occurs in response to increased workload and can result from high blood pressure, narrowing of the aortic valve, or other factors that stress the heart. LVH can lead to complications such as irregular heart rhythms and heart failure. Treatment depends on the underlying cause and may include medications or surgery.
Understanding the disease
Symptoms
Left ventricular hypertrophy itself doesn't cause symptoms. However, symptoms may occur as the strain on the heart worsens. These can include shortness of breath, especially while lying down, swelling of the legs, chest pain, often when exercising, sensation of rapid, fluttering or pounding heartbeats, called palpitations, fainting or a feeling of lightheadedness. If you have mild shortness of breath or other symptoms, such as palpitations, it is recommended to see your health care provider. Seek emergency care if you have severe difficulty breathing, severe lightheadedness or lose consciousness, or sudden, severe headache, difficulty speaking, or weakness on one side of your body.
Risk Factors
The risk factors for developing left ventricular hypertrophy include:
- Age: Left ventricular hypertrophy is more common in older people.
- High blood pressure: High blood pressure can cause heart muscle thickening.
- Weight: Being overweight increases the risk of high blood pressure and left ventricular hypertrophy.
- Family history: Changes in genes passed down through families may lead to left ventricular hypertrophy.
- Diabetes: Having diabetes increases the risk of left ventricular hypertrophy.
- Female gender: Women with high blood pressure are more likely to get the condition than are men with similar blood pressure measurements.
Development
Left ventricular hypertrophy (LVH) can develop due to various causes. The most common cause is uncontrolled high blood pressure, also known as hypertension, which strains the heart's lower left chamber (left ventricle), causing it to grow bigger. Other causes include narrowing of the aortic valve, a condition called aortic stenosis, and various types of cardiomyopathy. These conditions cause the heart muscle to work harder and may lead to LVH. Some types of cardiomyopathy, such as hypertrophic cardiomyopathy, can be inherited and linked to specific genetic changes. Restrictive cardiomyopathy can occur due to unknown reasons or other diseases affecting the heart. Arrhythmogenic right ventricular dysplasia is a rare type of cardiomyopathy that causes scar tissue to replace the muscle in the lower right heart chamber, leading to heart rhythm problems and typically caused by genetic changes.
Assessment and Diagnosis
Triage
You should see a doctor if you experience mild shortness of breath or other symptoms such as palpitations. If you have chest pain that lasts more than a few minutes, severe difficulty breathing, severe lightheadedness, or lose consciousness, seek emergency care. These symptoms may indicate a more severe condition, and prompt medical attention is necessary.
Diagnosis
To diagnose left ventricular hypertrophy (LVH), a healthcare provider will typically begin with a physical exam and ask questions about your symptoms and family health history. They will also check your blood pressure and listen to your heart using a stethoscope. If LVH is suspected, imaging tests may be performed to examine the heart, such as an echocardiogram, electrocardiogram (ECG or EKG), or heart MRI. These tests can help determine the thickness of the heart muscle and assess heart function.
Management and Treatment
Complications
Left ventricular hypertrophy can lead to various complications, including:
- Heart failure: The thickened and stiff left ventricle may have difficulty pumping blood effectively, leading to heart failure.
- Irregular heart rhythms (arrhythmias): The changes in heart structure and function can cause abnormal heart rhythms, which may be life-threatening.
- Ischemic heart disease: The increased blood pressure within the left ventricle can cause a reduction in blood flow to the heart, leading to a lack of oxygen in the heart muscle.
- Sudden cardiac arrest: Left ventricular hypertrophy can increase the risk of sudden, unexpected loss of heart function, breathing, and consciousness.
- Heart rhythm problems (arrhythmias): Abnormal heart rhythms may occur due to the thickened and stiff left ventricle.
- Fluid buildup (edema): The weakened state of the left ventricle may cause fluid to accumulate in the lungs, abdomen, legs, and feet.
- Poor growth and development: Children with left ventricular hypertrophy may experience growth and developmental delays.
- Blood clots: The condition can increase the risk of developing blood clots, which may lead to pulmonary embolism or stroke.
- Neurological complications: Left ventricular hypertrophy can sometimes cause developmental problems related to the brain and nervous system.
- Need for additional heart surgery or transplant: In severe cases, left ventricular hypertrophy may require additional surgical interventions or a heart transplant. It's important to manage risk factors and maintain a healthy lifestyle to prevent or minimize the development of left ventricular hypertrophy.
Prevention
left ventricular hypertrophy can be prevented by adopting healthy lifestyle changes. To prevent left ventricular hypertrophy caused by high blood pressure, follow these recommendations:
- Don't smoke
- Eat healthy foods
- Use less salt
- Limit or avoid alcohol
- Exercise regularly Additionally, reducing stress and maintaining a healthy weight can help lower the risk of developing conditions that might contribute to left ventricular hypertrophy. Regular health checkups, especially if you have high blood pressure or other risk factors, can help detect left ventricular hypertrophy early and enable timely treatment.
Treatment
The treatments for left ventricular hypertrophy depend on the underlying cause. If high blood pressure is the cause, treating high blood pressure can help reduce symptoms and potentially reverse the condition. Treatment options may include medications, such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), or beta blockers, to lower blood pressure and decrease the workload on the heart. In some cases, surgery may be necessary to remove blockages or repair damaged heart valves. Other treatments may include lifestyle changes, such as following a healthy diet, engaging in regular exercise, maintaining a healthy weight, and limiting alcohol consumption. Treatment for cardiomyopathy depends on the specific type and severity of the condition and may involve medications, device implantation, surgery, or, in severe cases, a heart transplant.
Preparing for medical consultation
To prepare for an appointment for left ventricular hypertrophy, you should:
- Make a list of your symptoms, including any that may seem unrelated to left ventricular hypertrophy, and when they began.
- Note down key medical information, including any other health conditions you have and a family history of heart disease.
- List all medications, vitamins, and supplements you take, including doses.
- Be aware of any pre-appointment restrictions, such as changing your diet or activity level.
- Write down questions to ask your healthcare provider, such as the cause of your symptoms, recommended tests, and potential treatments.
- Consider bringing a family member or friend for support and to help remember the information discussed during the appointment. Remember to discuss your diet and exercise habits with your provider, as well as any lifestyle changes or restrictions that may be necessary to manage your condition.