According to foodanddrinkjournal.com, left ventricular hypertrophy describes the tissue enlargement of the left myocardium (heart muscle) of the left heart ventricle. The medical term hypertrophy stands for tissue enlargement. The ventricles are the two cavities of the human heart located between the semilunar valves and the leaflets. The opposite of left ventricular hypertrophy is right ventricular hypertrophy, which affects the right myocardium of the right ventricle.
What is left ventricular hypertrophy?
A synonym is left ventricular hypertrophy. People who suffer from myocardial hypertrophy have a thickened heart muscle, either on the left or right side, depending on the condition. Left ventricular hypertrophy means an increasing heart muscle mass. The muscle fibers thicken and the cells enlarge.
The process of muscle gain is quite desirable in other areas of the body, such as when people engage in certain sports that build muscle mass. Most people associate something positive with the increase in muscle mass, but in the area of the heart this increase is life-threatening. In this area, a distinction must be made between the desired, physiological myocardial hypertrophy of athletes (sports heart) and myocardial hypertrophy due to continuous pressure, which ultimately becomes pathological.
It is an adaptation mechanism with which the heart adapts to the changed starting position due to the increased and chronic overload of the heart muscle in the left ventricle. Triggers can be hemodynamic or non-hemodynamic processes. Possible causes include arterial hypertension ( high blood pressure ), hypertrophic cardiomyopathy, or a heart valve defect.
Storage diseases such as Morbus Fabry rarely occur in this context. The most common cause of myocardial hypertrophy is constant pressure on the heart muscle caused by high blood pressure. Left ventricular hypertrophy leads to obstruction of blood ejection from the left ventricle due to aortic stenosis (narrowed heart valve). The pressure on the heart chamber wall increases. The heart resorts to a “trick” and tries to compensate for this undesirable process in the form of an increased load of muscle growth.
Cardiac hypertrophy caused by sports, on the other hand, is a desired phenomenon that differs physiologically from the pathological process in terms of its reversibility (ability to recover) and structure. Left ventricular hypertrophy appears more often than right ventricular hypertrophy. This means that the left ventricle is affected more often than the right ventricle.
Cardiac physicians distinguish between concentric (myocardial hypertrophy) and eccentric myocardial hypertrophy.
- The concentric form of muscle growth is caused by a pressure load on the heart. The volume of the affected ventricle is small, and the heart muscle walls thicken. Under normal circumstances, the walls of the heart are pliable. This compliance decreases during the bulking phase, which builds muscle tissue. Fibrous tissue is stored in the muscles.
- The eccentric form of heart muscle growth is caused by a volume load on the heart chambers. This is caused, for example, by an insufficiency of the aortic valve (leaking aortic valve). A more or less developed part of the blood that is in the systole (tension phase), which is normally ejected into the large aorta, rushes back into the heart chamber during the relaxation and filling phase (diastole).
Blood volume is increased by this process, which leads to myocardial hypertrophy, or dilatation of the ventricles. The left ventricle is hypertrophied more often than the right. The latter is particularly affected by high pressure in the pulmonary vessels. Hereditary forms of this disease, such as hypertrophic cardiomyopathy, are rare.
Symptoms, Ailments & Signs
As muscle tissue increases, the left ventricle stiffens due to the storage of non-muscle fibrous tissue that becomes lodged within the muscle fibers. This results in reduced elasticity of the heart chambers, which is also known as diastolic dysfunction. The main symptom occurs in the form of shortness of breath when the patient is subjected to physical stress.
It is a form of heart failure in which the systolic pump function and heart size are preserved. If the heart size increases by more than 500 grams due to muscle growth, there is an imbalance between the oxygen demand of the heart muscle and the actual oxygen supply.
The capillary blood system supplies the heart muscle with oxygen, but in view of muscle growth it reaches its limits because the organ grows too much or the blood vessels change in places due to calcification (atherosclerosis). The consequences are chest pain (angina pectoris), myocardial disorders, myocardial infarction and cardiac insufficiency.
Diagnosis & disease progression
Heart mass increases with age, even in healthy people. This normal increase in mass occurs due to an increasing wall thickness of the heart’s left ventricle. At the same time, the elasticity of the heart muscle decreases. As a result, blood pressure increases both at rest and during physical exertion. These symptoms lead to a diagnosis using an ultrasound scan of the heart called an echograph. Magnetic resonance imaging (MRI) provides further clinical findings.
In the worst case, left ventricular hypertrophy can lead to the death of the patient. For this reason, this condition must definitely be diagnosed and treated by a doctor. In this way, various consequential damages and other complications can be avoided. As a rule, those affected suffer from shortness of breath, which is associated with a reduced resilience of the patient.
It is not uncommon for severe tiredness to set in and those affected no longer actively participate in everyday life. Furthermore, severe physical stress is usually no longer possible for the person concerned or is associated with great exertion. Chest pain is also not uncommon. In the worst case, the affected person suffers a heart attack and dies from it.
Due to the heart failure, the life expectancy of the patient is significantly reduced due to left ventricular hypertrophy. Left ventricular hypertrophy can usually be treated with medication. However, those affected are dependent on lifelong therapy. In some cases, surgical interventions are necessary to prevent the patient from dying. Furthermore, no particular complications arise during the treatment.
When should you go to the doctor?
Complaints in the area of the heart should always be clarified by a doctor. If there is a feeling of tightness in the chest or inconsistencies in movements of the upper body, a doctor’s visit is advisable. Restricted breathing or a feeling of shortness of breath should be examined and treated. Heart palpitations, changes in blood pressure or cardiac arrhythmias are warning signals from the organism. To avoid a life-threatening condition, a doctor’s visit must be made. If physical activities can no longer be carried out as usual or if the usual performance drops, the person concerned needs medical care. A doctor’s visit is required to determine the cause.
Report chest pain or a stabbing sensation in the left breast to a doctor. If a feeling of pressure is felt in the chest, if there are problems with the blood flow, dizziness or nausea, a doctor’s visit is required. A diffuse feeling of illness, a general malaise or weakness should also be examined and treated by a doctor. Insomnia, anxiety or concentration problems are indications that should be followed up. A doctor’s visit is advisable as soon as the symptoms persist for several weeks or if they increase in intensity. If professional activities or usual sporting activities can only be carried out to a limited extent, a doctor is needed to clarify the cause. Overexertion should be avoided until the cause is determined.
Treatment & Therapy
In order to eliminate this disease or make it bearable, conservative therapies such as surgical removal of the heart valve defect and, in less severe cases, drug therapy to lower blood pressure are suitable. An ideal treatment for this heart disease does not yet exist. In most cases, the doctor prescribes calcium channel blockers or beta blockers.
A common drug is verapamil. These drugs lead to an improvement in coronary blood flow and systolic filling. Hypertrophy is not further stimulated with this therapy. ACE inhibitors increase the cardiac output due to the reduced blood pressure.
Outlook & Forecast
If left untreated, left ventricular hypertrophy leads to premature death of the affected person. The symptoms steadily increase until heart failure occurs. If heart failure is diagnosed very late or in an acute state, the prognosis is also unfavorable in a large number of cases. The patient needs an operation to relieve the existing symptoms. If this proceeds without further complications, his survival can be assured. Nevertheless, a change in lifestyle is necessary for a lasting improvement in health.
If the previous physical or emotional stress persists, long-term impairments can be observed in most cases. In particular, sports and professional activities should be changed and adapted to the conditions of the organism. Regular check-ups are also necessary after an operation in order to monitor heart activity and to be able to react as quickly as possible to irregularities. In acute situations, intensive medical care is required. Otherwise, long-term health problems can occur.
Overall, patients with left ventricular hypertrophy have a reduced life expectancy. They depend on the administration of medicines so that cardiac arrhythmias are reduced to a minimum. Nevertheless, they are exposed to increased risks due to their illness. If other diseases occur in the course of life, this always represents an additional burden on the heart.
It is a cardiovascular heart disease for which left ventricular hypertrophy is the main finding (predictor) in addition to the age of the patient. It acts as an independent risk factor for coronary diseases such as sudden cardiac death, stroke and heart failure. For this reason, there is no prevention in the clinical sense. A healthy lifestyle can help maintain normal heart muscle activity into old age. This includes plenty of exercise and avoiding too many stimulants such as alcohol and nicotine.
Medical support after left ventricular hypertrophy is essential. Since the patient must take beta-blockers, regular check-ups should be carried out. In the case of surgical therapy, it is important that those affected test or observe themselves and consult their doctor immediately after warning signals from their body. A blood count is used to determine any inflammation values.
In the first few weeks after the surgical procedure, rotational movements and transverse loads on the chest and heavy work should be avoided. Shorter flights are possible, but long-distance travel is not recommended for up to six months after the operation. Sporting activities should initially be limited to easy hikes, cycling and swimming and should be resumed very carefully. If chest pain occurs or if the patient finds the feeling of constriction disturbing, it is advisable to consult the doctor treating you.
You can do that yourself
A number of self-help measures can not only improve the symptoms of compensatory left ventricular hypertrophy, but in many cases also the objective diagnosis of the disease. It is of great advantage here if the causes that led to left ventricular hypertrophy are known.
In the majority of cases in which the compensatory thickening of the left ventricular muscular walls of the heart can be attributed to permanent arterial high blood pressure, all measures that combat the causes of the high blood pressure in addition to drug treatment of the hypertension help. For example, smokers can quit smokinggive up, and sporting activity within the scope of individual possibilities with moderate endurance can even lead to a gradual regression of the hypertrophied heart walls. Movement and physical activity should not be associated with abruptly changing performance requirements, as they occur in almost all dynamic ball games such as football, tennis, volleyball and similar sports. Golf has a particularly beneficial effect on the heart and the entire cardiovascular system. Brisk walking alternates with short phases of concentration, which serve to hit the ball.
However, the above self-help measures reach their limits when the disease is caused by mitral valve insufficiency or aortic valve stenosis. Avoiding sports with suddenly changing performance requirements also applies to hereditary hypertrophic cardiomyopathy.