What is Left Ventricular Hypertrophy?
Left ventricular hypertrophy is a disorder of the heart involving the enlargement or thickening of the wall of cardiac muscle situated in the chamber of the heart known as the left ventricle. The disease occurs as a result of several possible precipitating factors that prompt the heart to increase the amount of effort and power it exerts in order to supply blood to the entire body, such as heightened blood pressure.
The left ventricle is the chief chamber of the heart that takes helm over the task of delivering blood to the majority of the body. Although the heart is made up of four chambers in total, each one with its own designated areas that they are built to pump and supply blood to, the left atrium, the right atrium, and the right ventricle merely deliver blood to the lungs or to their adjacent chambers. The left ventricle, however, is easily distinguished as the chamber that puts forth the greatest amount of effort as it is responsible for pumping out oxygenated blood to nourish practically the entire human body as a whole.
Under certain circumstances, the heart may be required to work harder in order to steadily provide the needed amount of blood to the various organs in the body. The myocardium, the specialized cardiac muscle designed to rhythmically pump the blood into and out of the heart, may thicken and enlarge in an attempt to adapt to the increased workload. In the process of enlargement, the muscle eventually loses its elasticity and subsequently, loses its ability to effectively pump – drastically impairing the circulation of blood within the body. The condition can be life threatening if allowed to persist without prompt medical care.
Symptoms
Left ventricular hypertrophy will take a while to progress before it produces any observable symptoms. As the process is one that is gradual, the patient may not even experience any symptoms at all during the earlier stages of the disease as changes are too minor or miniscule to result in any obvious alterations in the body’s performance. However, if the causative factors responsible for the heart’s struggle are not done away with, the muscles within the left ventricle will thicken and harden enough to produce apparent, and often debilitating, symptoms. These include the following:
- Difficulty breathing
- Increased rate of respiration
- Patient is easily fatigued or tired out by normal physical activities
- Rapidly beating heart rhythm, otherwise known as palpitations
- Chest pain
- Light-headedness
- Episodes of spontaneously losing consciousness or fainting
The last few items on the list of symptoms are cause for alarm and indicate the need for emergency medical assistance. Should a patient experience any of the above signs, he or she should seek out prompt medical care before the condition is allowed to worsen.
Causes
Left ventricular hypertrophy occurs as a result of the heart’s adaptive reaction to any factor that may be requiring the heart to work harder than usual. In most instances of left ventricular hypertrophy, the disease develops due to an underlying condition of hypertension which brings about the need for the heart to hasten its pace in order to still effectively supply blood to the entire body despite the resistance of the heightened levels of blood pressure. The myocardium or heart muscle within the left ventricle enlarges and thickens in order to still effectively perform its critically important task. Although the changes in the heart muscle is meant as an adaptive move, the hypertrophy or enlargement of the muscles eventually robs the heart of the elasticity it requires to pump blood in the constant rhythm needed. In the long run, the hypertrophy ends up as a liability to the heart’s performance, preventing the left ventricle from keeping up with the essential constant delivery of blood the body needs.
Several underlying conditions can contribute to or influence the enlargement of the heart muscle in the left ventricle. Hypertension is the most common cause, setting the stage for left ventricular hypertrophy once a person’s blood pressure exceeds the normal level of 140/90 mm Hg. Aside from hypertension, the condition known as aortic valve stenosis is also a common cause of the hypertrophic changes in the heart. The disease involves the narrowing of the valve that comes between the left ventricle and the aorta, a major blood vessel in the body. Although the barrier may only exist within the aortic valve, the obstacle is enough to require the left ventricle to increase its efforts.
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Left ventricular hypertrophy can also result without succeeding an underlying disorder. The condition may occur in athletes who constantly undergo training in an attempt to improve their stamina. Under such circumstances, the heart can still react by adapting in order to accommodate the additional amount of work.
Treatment
The treatment for left ventricular hypertrophy depends on the cause of the condition. Doctors will aim to eliminate the cause of the heart’s enlargement in order to normalize the heart’s efforts and prevent incapacitation of the heart muscles.
If high blood pressure is determined as the root cause of the disease, doctors will usually devise a treatment regimen involving medications as well as lifestyle modifications. The patient may be prescribed medications that promote the reduction of blood pressure. These include thiazide diuretics which help by reducing the amount of fluid constantly circulating in the body, the reduction of the blood’s volume thus decreases blood pressure. Another type of medication used is angiotensin-converting enzyme inhibitors. These act on the blood vessels in the body by promoting their dilation, allowing better passage of blood and reduced blood pressure. in addition to the aforementioned types of medications are beta blockers and calcium channel blockers which both contributed to reducing blood pressure. Coupled with the use of drugs is the need for changes in the patient’s lifestyle. The patient will have to initiate a lifestyle and diet that improves heart function through engaging in regular physical exercise, avoiding smoking at all costs, and consuming a diet that is low in both sodium and fat as both types of food components take a toll on the heart’s performance.
In severe cases, the patient may have to undergo surgery in order to effectively restore proper heart function. An aortic valve repair or replacement is the surgical procedure carried out for patients with left ventricular hypertrophy resulting from aortic valve stenosis. Treatment is achieved through getting rid of the narrowed valve and substituting it with one that is healthy and wide enough to allow proper blood flow.
Left Ventricular Hypertrophy in Children
Left ventricular hypertrophy can occur as an inborn disease in infants and children, due to an underlying condition known as hypertrophic cardiomyopathy. Hypertrophic cardiomyopathy or HCM is a hereditary disease that involves an inborn abnormality of the cardiac muscles. The myocardium is unnaturally enlarged and thickened in this condition, thus causing the left ventricular hypertrophy. The presentation of the condition in children is the same as those in adults but detection is more difficult as children are less able to express their experiences as well as less likely to complain about any of the abnormal sensations they may undergo. The condition can be diagnosed with the help of tests such as an EKG or through the auscultation of the heart sounds by a doctor.
