What is Left Ventricular Hypertrophy (LVH)?

What is Left Ventricular Hypertrophy (LVH)?

LVH is a term for a heart’s left pumping chamber that has thickened and may not be
pumping efficiently. Sometimes problems like aortic stenosis or high blood
pressure overwork the heart muscle. In response to this pressure overload inside the
heart, heart muscle cells may respond by getting thicker along the inner walls of the
heart. This thickened wall can cause the left chamber to weaken, stiffen and lose
elasticity, which may prevent healthy blood flow.

What are the symptoms of LVH?

LVH may be present for many years without any noticeable symptoms at all. As the
condition worsens, symptoms may develop, such as:

 Shortness of breath
 Fatigue
 Chest pain (especially with exercise)
 Heart palpitations
 Dizziness or fainting

If you are experiencing some or all of these symptoms, speak to your doctor right
away. This cluster of symptoms can have several causes and should always be
discussed with your healthcare provider so that prompt attention can be given to identify
the reasons.
How is Left Ventricular Hypertrophy related to other heart
problems?
LVH usually happens as a result of other heart problems such as:

 High blood pressure

 Diabetes
 Heart valve problems like stenosis or regurgitation
 Arrhythmia
 Atrial fibrillation (AFib)
 Enlargement of the aorta

It is important to treat the causes of LVH early because it can lead to severe problems
like heart failure, sudden cardiac arrest and ischemic stroke.

How is LVH diagnosed?

Because LVH can develop silently over several years without symptoms, it can be
difficult to diagnose. However, a routine electrocardiogram (ECG or EKG) or
echocardiogram can usually diagnose LVH, even before symptoms become
noticeable. MRI imaging of the heart can also diagnose LVH.

What are the treatment options for LVH?

LVH can often be corrected by treating the underlying problem causing the heart to
work too hard. Depending on the type of damage that has occurred, treatment
measures may include medications and heart-healthy lifestyle changes to help reduce
the load on the heart. If LVH is caused by a heart valve problem, surgery may be
needed to repair the valve.

Can LVH be reversed?

For some people, yes. There are a number of studies pointing to improved outcomes for
people who are treated for LVH.

Causes

Left ventricular hypertrophy can occur when some factor makes your heart work harder
than normal to pump blood to your body.

Factors that can cause your heart to work harder include:

  High blood pressure (hypertension). This is the most common cause of left
ventricular hypertrophy. More than one-third of people show evidence of left
ventricular hypertrophy at the time of their diagnosis with hypertension.

 Aortic valve stenosis. This disease is a narrowing of the aortic valve that
separates the left ventricle from the large blood vessel leaving your heart (aorta).
The narrowing of the aortic valve requires the left ventricle to work harder to pump
blood into the aorta.

 Hypertrophic cardiomyopathy. This genetic disease occurs when the heart

muscle becomes abnormally thick, even with completely normal blood pressure,
making it harder for the heart to pump blood.

 Athletic training. Intense, prolonged endurance and strength training can cause
the heart to adapt to handle the extra workload. It's unclear whether this athletic
type of left ventricle hypertrophy can lead to stiffening of the heart muscle and
disease.

Risk factors

In addition to hypertension and aortic valve stenosis, factors that increase your risk of
left ventricular hypertrophy include:

 Age. Left ventricular hypertrophy is more common in older people.

 Weight. Being overweight increases your risk of high blood pressure and left
ventricular hypertrophy.

 Family history. Certain genetic conditions are associated with developing left
ventricular hypertrophy.

 Diabetes. Left ventricular hypertrophy has been found to be linked to a higher risk
of diabetes.

 Race. African-Americans are at higher risk of left ventricular hypertrophy than are
white people with similar blood pressure measurements.

 Sex. Women with hypertension are at higher risk of left ventricular hypertrophy
than are men with similar blood pressure measurements.
Complications

Left ventricular hypertrophy changes the structure and working of the heart. The
enlarged left ventricle can:

 Weaken

 Stiffen and lose elasticity, preventing the chamber from filling properly and
increasing pressure in the heart

 Compress the chamber's blood vessels (coronary arteries) and restrict its supply of
blood

As a result of these changes, complications of left ventricular hypertrophy include:

 Reduced blood supply to the heart

 Inability of the heart to pump enough blood to your body (heart failure)

 Abnormal heart rhythm (arrhythmia)

 Irregular, often rapid heartbeat (atrial fibrillation) that decreases blood flow to the
body

 Insufficient supply of oxygen to the heart (ischemic heart disease)

 Stroke

 Sudden, unexpected loss of heart function, breathing and consciousness (sudden

cardiac arrest)

Prevention

The best way to prevent left ventricular hypertrophy caused by high blood pressure is to
maintain healthy blood pressure. To better manage your blood pressure:

 Monitor high blood pressure. Purchase a home blood pressure measuring

device and check your blood pressure frequently. Schedule regular checkups with
your doctor.
  Make time for physical activity. Regular physical activity helps to lower blood
pressure and keep it at normal levels. Aim for 30 minutes of moderate physical
activity most days of the week.

 Eat a healthy diet. Avoid foods that are high in saturated fat and salt, and eat
more fruits and vegetables. Avoid alcoholic beverages or drink them in moderation.

 Quit smoking. Giving up smoking improves your overall health and prevents heart
attacks.

Massie, BM : Myocardial hypertrophy and cardiac failure: A complex interrelationship. Am J

Med 1983; 75: 67–74.

Diez, J, Querejeta, R, Lopez, B, Gonzalez, A, Larman, M, Martinez, Ubago JL: Losartan-dependent

regression of myocardial fibrosis is associated with reduction of left ventricular chamber stiffness in
hypertensive patients. Circulation 2002; 105: 2512–2517.

Kahan, T : The importance of left ventricular hypertrophy in human hypertension. J Hypertens 1998;
16 (Suppl 7): S23–S29.