HEART & BLOOD Cardiovascular System • Aortic aneurysm • High blood pressure (hypertension) • High blood cholesterol • Thrombophlebitis • Rheumatic fever • Varicose veins • Heart arrhythmias • Atrial fibrillation • Endocarditis • Aortic valve stenosis • Aortic valve regurgitation • Mitral valve stenosis • Mitral valve regurgitation • Pulmonary hypertension • Raynaud's disease • Long QT syndrome • Mitral valve prolapse • Pericarditis • Cardiomyopathy • Myocarditis • Arteriosclerosis / Atherosclerosis • Peripheral arterial disease (PAD) • Low blood pressure (hypotension) • Aortic dissection • Lymphedema • Pulmonary valve stenosis • Ventricular septal defect (VSD) • Tetralogy of Fallot • Coarctation of the aorta • Atrial septal defect (ASD) • Patent ductus arteriosus (PDA) • Left ventricular hypertrophy • Bundle branch block • Heart murmurs • Patent foramen ovale • Transposition of the great arteries • Hypoplastic left heart syndrome • Sudden cardiac arrest • Prehypertension • Tricuspid atresia • Ebstein's anomaly • Buerger's disease

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Left ventricular hypertrophy refers to a thickening of your heart muscle's main pumping chamber (left ventricle). Although left ventricular hypertrophy itself isn't a disease, it is a marker of an underlying health problem.

The thickened muscle usually develops in response to chronic high blood pressure or excessive blood volume filling the left ventricle, which creates more work for your heart. Over time, the overdeveloped heart muscle may wear out and eventually fail.

The incidence of left ventricular hypertrophy (LVH) increases with age and is more common in people who have high blood pressure or have other heart problems. Whatever the cause, left ventricular hypertrophy places you at an increased risk of major heart and blood vessel complications, compared with people without the condition.

You can reduce your risk of developing left ventricular hypertrophy by controlling high blood pressure or by getting treatment for other conditions that can lead to left ventricular hypertrophy.

Signs and symptoms of left ventricular hypertrophy depend on the underlying cause. Left ventricular hypertrophy usually develops slowly, so there may be no signs or symptoms for many years or none at all. If signs or symptoms are present, they may include:

• Shortness of breath
• Chest pain
• Irregular heartbeats
• Dizziness
• Fainting

Your heart muscle responds to an increased workload much like your arm muscles respond to weightlifting — by enlarging and thickening. As the muscle cells of your heart increase in size, the heart wall widens. However, unlike your biceps muscle, which rests when you put down the dumbbell, your heart muscle must work nonstop.

Left ventricular hypertrophy may take up anywhere from weeks to years to develop. Over time, the heart muscle becomes "stiff" and the amount of blood that the heart can effectively pump out to the body begins to drop. Left untreated, the overdeveloped heart muscle will wear out and eventually fail.

Left ventricular hypertrophy usually develops in response to excessive blood pressure (pressure overload) or excessive blood volume filling the left ventricle (volume overload).

Pressure overload
Causes of pressure overload include:

• Hypertension. Blood pressure is determined by the amount of blood pumped by the heart and how the blood vessels respond to the pressure (resistance). High blood pressure is the most common cause of left ventricular hypertrophy.
• Aortic stenosis. This is a condition in which there's a narrowing of the aortic valve, the flap separating your heart from the aorta, the large blood vessel that branches off your heart and delivers oxygen-rich blood to your body. When the aortic valve is narrowed, blood flow from the heart into the aorta and on to your body is obstructed. Aortic stenosis causes blood pressure to build in the left ventricle.

Volume overload
Causes of volume overload include:

• Aortic valve regurgitation. Aortic valve regurgitation is a condition in which the heart valve separating the left ventricle and the aorta doesn't close properly, resulting in some blood flowing backward into the left ventricle. This increases the volume of blood in the left ventricle.
• Dilated cardiomyopathy. Cardiomyopathy refers to a weakening of the heart muscle. The condition may be inherited or acquired later in life. Dilated cardiomyopathy involves the enlargement of one or more chambers of your heart. An enlarged left ventricle is able to fill with more blood and requires more force to pump it out to your body.

Left ventricular hypertrophy can occur in the absence of pressure or volume overload. An inherited condition that causes a thickening in part or all of the heart (hypertrophic cardiomyopathy) can cause left ventricular hypertrophy.

High blood pressure is the key risk factor for left ventricular hypertrophy because your heart must work against increased pressure. Other risk factors include:

• Age. Age is an important risk factor because conditions that increase the risk of left ventricular hypertrophy, such as high blood pressure, tend to develop as you get older.
• Obesity. Obesity refers to an excess storage of body fat. If you're overweight, your heart has to work harder to deliver blood to your organs.
• Pre-existing coronary disease. Coronary disease refers to blocked blood vessels that supply blood to your heart muscle. If your heart muscle isn't receiving enough blood due to clogged vessels, your heart responds by pumping more forcefully.

If you have signs or symptoms such as severe chest pain, fainting or sudden onset of shortness of breath, contact your doctor or call 911 or emergency medical help. While experiencing these signs or symptoms doesn't necessarily mean that you have a serious problem, it's best to get checked quickly. Early detection and treatment of a serious heart problem may help save your life.

Signs and symptoms of a health problem that may lead to a diagnosis of left ventricular hypertrophy are often discovered during a physical exam. Your doctor may detect elevated blood pressure or hear abnormal heart sounds in your chest. To make a definitive diagnosis, your doctor uses one of the following two tests:

• Echocardiogram. The echocardiogram is the preferred technique for diagnosing left ventricular hypertrophy. This test uses high-pitched sound waves to produce an image of your heart. Sound waves bounce off your heart and produce moving images that can be viewed on a video screen. Echocardiograms determine the thickness of the heart wall and can help detect other heart abnormalities that may have caused left ventricular hypertrophy, such as aortic stenosis.
• Electrocardiogram. An electrocardiogram records the electrical activity in your heart each time it contracts. During this procedure, patches with wires (electrodes) are placed on your chest, wrists and ankles. The electrodes measure electrical activity, which is recorded on paper. If left ventricular hypertrophy is present, the electrocardiogram detects abnormal electrical activity.

The risk of complications depends on the severity of the left ventricular hypertrophy — the thicker the muscles in the left ventricle, the greater your risk of complications. The most common complications include:

• Arrhythmia. An arrhythmia is an abnormal heart rhythm — that may be felt as a fluttering in the chest — resulting from a disruption in the electrical activity of your heart. Arrhythmias range from mild to life-threatening.
• Congestive heart failure. If you develop left ventricular hypertrophy, your heart may lose its ability to deliver enough blood to meet your body's demands. As your heart fails, fluid may also back up (congest) in your lungs.
• Ischemic heart disease. A thickened heart muscle compresses the small vessels feeding your heart, resulting in an insufficient amount of blood to your heart. Without adequate blood flow to the heart muscle, your heart becomes starved for oxygen (ischemic).
• Unexpected sudden death. People with left ventricular hypertrophy are more likely to have an irregular heartbeat than are people without left ventricular hypertrophy. Severe irregular heartbeats are associated with an increased risk of sudden death.

Treatment for left ventricular hypertrophy focuses on the underlying cause of the condition. Depending on the cause, treatment may involve medication or surgery:

• Treating high blood pressure. High blood pressure is the most common cause of left ventricular hypertrophy. Doctors often prescribe medications to lower blood pressure, such as "water pills" (diuretics). Severe high blood pressure requiring intensive care may be treated with drugs given through a vein (intravenous) called diazoxide and sodium nitroprusside. Your doctor may also recommend that you follow a low-salt diet.
• Aortic valve replacement. Leaky aortic valves allow blood to flow backward into your heart. Replacing a defective valve helps keep blood flowing normally into the aorta.
• Surgery for hypertrophic cardiomyopathy. Hypertrophic cardiomyopathy is an inherited condition that causes a thickening in all or part of your heart. If the hypertrophic cardiomyopathy is severe, your doctor may recommend removal of a portion of the thickened muscle wall that interferes with blood flow.

The best way to help prevent left ventricular hypertrophy is to keep your blood pressure within the limits recommended by your doctor. Here are a few tips to better manage your blood pressure:

• Monitor high blood pressure. If you have high blood pressure, get a home blood pressure measuring device and check your blood pressure frequently. Schedule regular checkups with your doctor.
• Make time for exercise. Regular exercise helps to lower blood pressure. Aim to engage in 30 minutes of moderate activity at least five times a week. Talk to your doctor about whether you need to restrict certain physical activities, such as weightlifting, which may temporarily raise your blood pressure.
• Watch your diet. Eat foods high in fat and salt sparingly and increase your consumption of vegetables, fruits and low-fat dairy products. Drink alcohol and caffeinated beverages in moderation.

In addition to controlling high blood pressure, it's important to monitor other health conditions that increase your risk of heart disease, including diabetes and high blood cholesterol.