Left ventricular hypertrophy

Материал из CardioWiki


Left ventricular hypertrophy is the growth and increase in the muscle mass of this wall of the heart, which leads to a change in the shape and size of the entire organ or thickening of the interventricular septum. This pathology is usually detected by chance during ultrasound examination of the heart or ECG. This symptom of many diseases can last for a long time absolutely imperceptibly and be a harbinger of serious diseases or pathologies of the heart. Also, such a dangerous condition of the myocardium in the absence of adequate and timely treatment can lead to an increased risk of myocardial infarction or stroke, and hence, to the onset of a fatal outcome.

In most cases, left ventricular hypertrophy becomes a consequence of hypertension or long-term hypertension caused by other diseases

Predisposing factors for increasing the size and weight of the left ventricle can be:

  • congenital malformations of the heart: aortic stenosis or coarctation, pulmonary arteries or left ventricular hypoplasia, lack of communication between right atrium and ventricle, single ventricle of heart, common aortic trunk;
  • acquired heart defects: mitral insufficiency, constriction of the aortic valve;
  • cardiomyopathy;
  • ischaemic heart disease;
  • intense and prolonged physical activity (for athletes or people whose profession is associated with intense physical activities);
  • Fabry's disease;
  • atherosclerosis;
  • obesity;
  • diabetes mellitus;
  • adynamia;
  • severe intense physical activity;
  • apnea (often observed in men and women in the postmenopausal period);
  • smoking, alcoholism, etc.

The formation of hypertrophy of the left ventricle is caused by a complicated or disturbed outflow of blood from the heart into the large circulation. Because of this, the walls of the left ventricle constantly experience additional stress, and the adapting heart begins to "build up its mass" due to the growth of cardiomyocytes. Coronary vessels "do not have time" as quickly grow after the myocardium, and the nutrition of the heart becomes insufficient. Also, due to the increase in the mass of the myocardium, zones of anomalous conductivity and activity can form in its thickness, which in turn leads to the development of arrhythmias.

In some cases, myocardial hypertrophy is also observed in absolutely healthy people (athletes or people engaged in heavy physical labor). It is caused by considerable physical stresses, which lead to intense heart work. In such cases, the physiological hypertrophy of the left ventricle, while observing the rational loading regimen, as a rule, does not pass into the pathological stage, but the risk of developing various cardiovascular pathologies nevertheless increases.

In the compensation stage the left ventricle performs well, and the patient does not feel any hypertrophy of the myocardium. In such cases, cardiac wall hypertrophy can be detected accidentally during ECG or ultrasound examination of the heart.

At approach of sub compensation stage an occasion for the reference to the cardiologist can be appearing after physical exertion:

  • increased fatigue;
  • darkening in the eyes;
  • muscle weakness;
  • dyspnea;
  • minor interruptions in the work of the heart.

In some cases, the above-described signs of the sub compensation stage do not appear in healthy people, but develop only in persons with already existing defects or pathologies of the heart.

The symptoms of myocardial hypertrophy are most pronounced at the onset of the decompensation stage. They can manifest themselves with such nonspecific signs:

  • frequent drowsiness and fatigue;
  • general weakness;
  • sleep disorders;
  • headache;
  • frequent pulse;
  • instability of blood pressure;
  • arrhythmia;
  • cardialgia resembling angina attacks;
  • pain in the chest;
  • dyspnea;
  • muscle weakness.

More specific manifestations of left ventricular hypertrophy can become such symptoms:

  • swelling on the face in the evening;
  • decrease in pulse voltage;
  • atrial fibrillation;
  • dry cough.

Also, in the stage of decompensation, the patient may experience episodes of cardiac asthma, since the left ventricular myocardium is unable to pump the required amount of blood, and blood stasis is formed in pulmonary circulation.

Hypertrophy of the left ventricle can be complicated by such severe consequences:

The main goal of treatment of left ventricular hypertrophy is aimed at eliminating the causes causing it and reducing the size of the cardiac chamber. For this, the patient is recommended to change lifestyle and eliminate risk factors, drug therapy and, if necessary, surgical treatment.

Change in lifestyle and elimination of risk factors

  1. Control of blood pressure. The patient is recommended to regularly measure blood pressure.
  2. Elimination of psychoemotional stress and stressful situations.
  3. Rational physical activity.
  4. Refusal to smoke and drink alcohol.
  5. Getting rid of excess weight and preventing obesity.
  6. Regular exercise and outdoor exercise.
  7. Reduce the amount of salt consumed, foods high in animal fats and fried, smoked, fatty and flour dishes.

This pathology can be detected using ECG Dongle Full [1].