Left Ventricular Hypertrophy (LVH)

Introduction

Left ventricular hypertrophy (LVH) is a condition where the muscle wall of the left ventricle of the heart thickens. This can be a response to increased workload, often caused by high blood pressure (hypertension) or other heart conditions.

Causes of LVH

• Hypertension – The most common cause. Increased blood pressure forces the heart to work harder, leading to muscle thickening.
• Aortic stenosis – A narrowing of the aortic valve can increase resistance and strain on the heart.
• Hypertrophic cardiomyopathy – A genetic disorder where the heart muscle thickens abnormally.
• Athlete's heart – Sometimes, prolonged athletic training can cause mild hypertrophy.

Symptoms

• Shortness of breath
• Chest pain (angina)
• Palpitations or irregular heartbeats
• Dizziness or fainting
• Fatigue

Potential Complications

Untreated LVH can lead to: - Heart failure – The heart becomes too stiff to fill properly or too weak to pump effectively. - Arrhythmias – Irregular heart rhythms that can be dangerous. - Increased risk of heart attack and stroke – Due to poor heart function and possible blood clot formation.

Diagnosis

• Electrocardiogram (ECG) – Can suggest LVH by showing specific electrical changes.
• Echocardiogram (heart ultrasound) – The best imaging tool to measure heart muscle thickness.
• MRI Scan – Provides detailed images of the heart’s structure.
• Blood pressure monitoring – Identifying and treating high blood pressure early can prevent LVH.

Treatment

1. Lifestyle Changes

• Controlling blood pressure through diet (low salt, DASH diet) and regular exercise.
• Maintaining a healthy weight.
• Quitting smoking and reducing alcohol intake.

2. Medications

• Antihypertensives: Including ACE inhibitors, ARBs, beta-blockers, and calcium channel blockers.
• Diuretics: Help reduce blood pressure and heart workload.

3. Surgical Options (if needed)

• Valve replacement (for patients with aortic stenosis).
• Myectomy (for severe hypertrophic cardiomyopathy).

Conclusion

LVH is a serious condition, but early diagnosis and treatment can dramatically improve outcomes. Controlling high blood pressure and addressing underlying causes is key to heart health.

Source recommendations

1. American Heart Association Guidelines for Hypertension

1. https://www.heart.org/en/health-topics/high-blood-pressure
2. https://www.ahajournals.org/doi/10.1161/hyp.0000000000000065
3. https://www.heart.org/-/media/Files/Professional/Quality-Improvement/Pain-Management/AHA-GUIDELINEDRIVEN-MANAGEMENT-OF-HYPERTENSION--AN-EVIDENCEBASED-UPDATE.pdf
4. https://professional.heart.org/en/science-news/2017-hypertension-clinical-guidelines
5. https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings/monitoring-your-blood-pressure-at-home

2. European Society of Cardiology Guidelines on Hypertension

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Elevated-Blood-Pressure-and-Hypertension
2. https://academic.oup.com/eurheartj/article/45/38/3912/7741010
3. https://pubmed.ncbi.nlm.nih.gov/37345492/
4. https://www.ejinme.com/article/S0953-6205(24)00238-3/fulltext
5. https://academic.oup.com/eurheartj/article/39/33/3021/5079119

3. ESC Guidelines on Cardiomyopathies

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Cardiomyopathy-Guidelines
2. https://academic.oup.com/eurheartj/article/44/37/3503/7246608
3. https://pubmed.ncbi.nlm.nih.gov/37622657/
4. https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2023/08/30/02/53/2023-esc-guidelines-for-cardiomyopathies-esc-2023
5. https://pubmed.ncbi.nlm.nih.gov/25173338/