What Causes Left Ventricular Hypertrophy (LVH)?

left ventricular hypertrophy (LVH) is an increase in the mass (weight) of the left ventricle, the main pumping chamber of the heart. LVH develops when the force or volume of blood within the ventricle is excessive. Common conditions that cause LVH are high blood pressure and aortic stenosis (valve heart disease).

Because LVH often occurs silently over many years, it is often routinely diagnosed. electrocardiogram (ECG). LVH can often be reduced or reversed by treating the underlying cause; This requires adopting healthy lifestyle behaviors, taking medications, or undergoing surgery.

What Causes Anatomical Changes in LVH?

The left ventricle is one of the four parts of the heart rooms. It pumps oxygen-rich blood to the body. aortaIt is the largest artery in the body that carries blood to vital organs.

Over time, the left ventricle is damaged by normal aging and unchangeable factors such as ethnicity and high blood pressure (hypertension). diabetes, obesityAnd metabolic syndrome (a group of conditions that occur together to increase the risk of type 2 diabetes, stroke, and heart disease).

Left ventricular hypertrophy is a type of heart-related remodeling that involves an increase in left ventricular mass.

LVH is a response to one or both of the following:

• Overload of blood pressure within the LV causes an increase in wall thickness.
• Overload of blood volume in the LV ventricle causes an increase in the size of the chamber.

Related Terms

Two of the most common causes of LVH are:

• Hypertension It is a condition in which the force or effect of blood on the artery walls is very high. Hypertension causes thickening of the heart muscle, which creates increased pressure within the left ventricle, making it work extra hard to pump blood into the aorta.
• aortic stenosis It narrows the aortic valve, preventing blood flow from the left ventricle to the aorta. Increased pressure within the left ventricle causes the walls to thicken.

Other causes of LVH include:

• Aortic regurgitation This is when the aortic valve leaks, causing blood flow to reverse (in the wrong direction) back into the left ventricle.
• Mitral regurgitation When leakage occurs in the mitral valve, it causes the flow of blood to flow in the opposite direction (in the wrong direction) back into the left atrium (the upper chamber above the left ventricle).
• Dilated cardiomyopathy It is characterized by stretching and dilation of the ventricles (usually starting on the left and spreading to the right). Possible reasons for this situation are: coronary artery diseasealcohol and infection.
• Hypertrophic cardiomyopathy It is a condition that runs in families and is characterized by thickening of the left ventricular walls. This condition is the most common cause of sudden cardiac death in young individuals and competitive athletes in North America.
• A. ventricular septal defect It is a hole in the wall between the right and left ventricles. This is the most common congenital (present at birth) heart disease. In a large VSD, blood flows incorrectly from the left to the right ventricle, straining the lung arteries and the left side of the heart. The left ventricle increases in size to compensate for the extra blood.
• One “The heart of the athlete” It refers to the heart-related changes that occur in athletes as an adaptation to intense physical training. Although these heart-related changes meet the criteria for left ventricular hypertrophy, they are considered harmless because they are pathologically different from changes caused by high blood pressure, for example.

Symptoms and Onset

Left ventricular hypertrophy usually causes no symptoms for many years.

Over time, as the left ventricle thickens and/or enlarges, the heart muscle becomes weaker and stiffer and is no longer able to pump blood well enough.

Left-sided heart failure It may then occur, causing the following symptoms:

In addition to heart failure, LVH is associated with the following complications:

ECG Findings

One electrocardiogram Evaluating the electrical activity of the heart (EKG or EKG) is a readily available tool for detecting LVH.

During an ECG, the person lies on a bed or table and small, adhesive pads are strategically positioned on the chest, arms, and legs. Wires connect the pads to a machine and transfer the heart’s electrical activity to paper. The paper is divided into large and small boxes to calculate time and distance.

The heart’s electrical activity looks like wavy, spiky lines on paper.

These lines consist of the following three parts:

• P wave It is a representation of blood pumped from the atria (upper chambers of the heart) to the ventricles (lower chambers of the heart).
• QRS complex It consists of three waves and represents the pumping of blood from the heart (to the lungs or aorta).
• T wave It represents the relaxation of the ventricles before the above “pumping blood” cycle repeats.

Many different criteria have been developed for ECG findings in LVH, but five general findings of LVH are:

• One Increased QRS voltage (height of the waves) occurs because there are more muscle fibers in the left ventricle to conduct electrical signals.
• QRS complex expands because electrical signals travel a longer distance within the left ventricle.
• Left axis deviation It occurs because the direction of electrical activity moving in the heart is distorted towards the left.
• ST changes It occurs when electrical signals move differently in the left ventricle due to reorganization. This finding may mimic that seen with a ST elevation (“STEMI”) heart attack (When an artery feeding the heart muscle is completely blocked).
• Left atrial abnormality It is accompanied by thickening, enlargement, or both of the left atrium, occurring in response to chronic left ventricular hypertrophy.

Note that although the ECG is a reasonable “first step” tool for identifying and eventually monitoring LVH, imaging tests can more accurately diagnose the condition and its underlying cause.

These imaging tests include:

• One echocardiogram It is an ultrasound of the heart muscle. It uses sound waves to visualize the heart’s size, shape, thickness, movement, pumping ability, and how well the valves are working.
• Cardiac magnetic resonance imaging (MRI) It uses magnetic fields and radio waves to produce three-dimensional images of the heart. It provides a more precise assessment of left ventricular structure and function than an echocardiogram.

Does Treatment Reverse LVH?

Depending on the cause, LVH may be reduced or reversed. LVH regression. For example, if LVH is caused by high blood pressure, lowering blood pressure may cause LVH to regress.

Even better, research suggests that LVH regression improves the cardiovascular system prognosis By intensive blood pressure lowering, especially by maintaining blood pressure below 120/80 mm Hg (millimeters of mercury).

classes Medicines used to lower blood pressure add:

Similarly, if LVH is caused by a heart valve problem such as aortic stenosis, surgery may require repair or replace valve It can be done to achieve regression of LVH and improve the functioning of the heart.

The Importance of Lifestyle Changes and Habits

If you or someone you love has LVH, treatment is aimed at managing or correcting the underlying cause. Although medication and/or surgery may be necessary, adopting heart-healthy lifestyle behaviors also plays an important role.

Heart-healthy behaviors include:

• Maintaining a healthy weight
• Exercise (with the guidance of a healthcare professional if you have heart/lung/joint or other health problems)
• food heart-healthy foods such as fruits and vegetables and limiting excess salt
• avoiding smoking and limiting or avoiding alcohol
• Appropriately managing underlying causes of LVH (for example, taking high blood pressure medication as directed)

Summary

Left ventricular hypertrophy (LVH) is an increase in left ventricular weight due to thickening of the left ventricular walls, increased space within the left ventricle, or both. The two most common causes of LVH are high blood pressure and aortic stenosis (heart valve disease).

LVH symptoms often remain silent for years until the heart weakens and stops pumping blood efficiently. When the left heart begins to fail, symptoms such as difficulty breathing, chest pain, fatigue and dizziness develop.

LVH can usually be diagnosed with an electrocardiogram (ECG), echocardiogram (ultrasound of the heart), or cardiac MRI (three-dimensional images of the heart) before symptoms develop.

LVH can usually be corrected by treating the underlying cause (for example, by intensively lowering high blood pressure or repairing/replacing a malfunctioning aortic valve). Losing weight if you are overweight or obese and adopting heart-healthy habits, such as staying physically active, are also essential for maintaining a structurally and functionally healthy left ventricle.

If the underlying causes of LVH are not addressed, potentially life-threatening problems such as heart attack, stroke, or abnormal heart rhythms can develop.