Definition and Overview

Left ventricular hypertrophy (LVH) is a disorder that increases the risk of heart attack and stroke. To better understand the condition, it helps to define the terms. The heart’s left ventricle is one of the organ’s two large chambers. It pumps the blood it receives from the left atrium. It is described as hypertrophic if its walls have become enlarged or thickened. LVH is often observed in people with uncontrolled high blood pressure (HBP).

LVH occurs when the heart is forced to work harder to pump enough blood to the rest of the body. It causes chest pain, shortness of breath, and palpitations. Unless treated promptly, LVH can progress. In severe cases, the blood flow to the rest of the body can be significantly reduced. This can lead to life-threatening conditions.

The good news is that LVH can be corrected. It is often adequately treated with medications and by making healthy lifestyle changes. Surgery is also an option to improve blood flow to the left ventricle. The prognosis for patients with LVH is often good if they seek treatment right away.

Causes of Condition

As mentioned above, many cases of LVH are caused by uncontrolled high blood pressure. HBP is a chronic medical condition marked by elevated blood pressure in the arteries. LVH can also be caused by a narrowed aortic valve. This reduces the amount of blood that flows from the left ventricle to the aorta. Both conditions force the heart or the left ventricle to work harder in order to provide enough supply of blood to the rest of the body.

LVH can also occur as a result of diabetes and arrhythmias.

Key Symptoms

LVH interferes with blood circulation. Different organs of the body, such as the brain and the heart, can lose some or all of their function if their blood supply is reduced. This can lead to abnormal heart rhythms, shortness of breath, and chest pain.

If not treated promptly, the condition can lead to heart failure, stroke, and sudden cardiac arrest. All of these conditions can lead to death.

Who to See and Types of Treatments Available

Patients with symptoms listed above are highly advised to consult their doctors. This is crucial, especially if they have HBP and recurrent chest pains that last for more than a couple of minutes. General doctors can carry out an initial assessment. If they suspect problems related to the heart, they refer the patient to a heart specialist.

Tests to diagnose LVH are the following:

  • A standard physical exam - For this test, the doctor will check the patient’s heartbeat and blood pressure. He or she will also take note if the patient is showing physical signs of the condition.

  • Review of medical history - Patients are asked if they have a history of certain diseases or disorders. These include diabetes and HBP. They are also asked if they have a family history of heart disease.

  • Heart function tests - If the results of initial tests suggest an abnormality, the doctor will proceed with heart function tests. These help doctors understand how well the heart is working. These tests may include an ECG, echocardiogram, and exercise stress test.

  • MRI of the heart - Magnetic resonance imaging is a noninvasive test that uses strong magnetic fields and radio waves. It provides detailed images of the heart. It is often used to evaluate the condition of the organ as well as its valves and chambers. It is also useful in assessing how well the blood flows through the heart’s blood vessels. It can confirm if the left ventricle has thickened.

Treatment of LVH focuses on treating the condition that caused it. Below is the list of the most common causes and how they are treated:

  • High blood pressure - HBP is managed with drug therapy. Doctors often prescribe medications that make the blood vessels wider. Patients are also advised to make healthy lifestyle changes. It is important that they eat a well-balanced diet. They must also lessen their salt intake. They are advised against drinking alcohol and smoking cigarettes. They must also exercise on a regular basis. In many cases, HBP is adequately managed with these measures.

  • Narrowed aortic valve - This can be treated by repairing or replacing the damaged aortic valve. Its repair may involve separating the cusps that have fused. It may also involve widening its opening. If the valve is damaged beyond repair, the doctor will replace it. For this procedure, a biological or mechanical valve can be used.

There are many factors to consider when patients undergo valve repair or replacement surgery. First is the technique to be used. Patients can choose between open-heart or minimally invasive surgery. The latter is performed without making a huge incision in the chest area. Although it is widely preferred, some patients do not qualify for it. Doctors must also decide if they are going to use a biological or mechanical valve. Both have advantages and disadvantages. The latter can last 20 years. Thus, surgery to replace it is not often needed. Tissue valves, on the other hand, may last only 10 years. But unlike mechanical valves, they often do not cause blood clots. Thus, patients do not have to take warfarin for the rest of their lives.

Doctors will decide on the best option depending on the patient’s preferences and unique circumstances.

References:

  • Lavie CJ, et al. Impact of echocardiographic left ventricular geometry on clinical prognosis. Progress in Cardiovascular Diseases. 2014;57:3.

  • Mann DL, et al. Systemic hypertension: Management. In: Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2014.

  • How can high blood pressure be prevented? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/hbp/prevention.

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