Under the left ventricular myocardial hypertrophy is understood an abnormal state of the heart, which is characterized by an increase in the mass of the heart muscle. Often, the pathology is detected by chance during an ECG or ultrasound.
For a long time, it can be asymptomatic, and portend serious heart disease. Without proper and adequate treatment, this condition often leads to an increased risk of heart attacks or strokes, which ultimately leads to death.
The muscle cells of the heart, called cardiomyocytes, lack the ability to divide, the development of myocardial hypertrophy occurs due to an increase in the number of intracellular structures and the volume of the cytoplasm. The consequence of this is a change in the size of the cells of the heart muscle, and an increase in myocardial mass.
The pathology under consideration is an adaptive process, that is, it develops in response to all kinds of disturbances that impede the normal activity of the myocardium. Such conditions force the heart muscle to contract with an increased load.
Which contributes to the strengthening of metabolic processes, the growth of cell mass and tissue volume in the myocardium.
At an early stage of its development, the analyzed LV disease is adaptive, and normal blood circulation is maintained by the heart by increasing the mass of this organ. But over time, inhibition of myocardial function occurs, and hypertrophy is replaced by atrophy, which, in turn, is the opposite phenomenon. That is, there is a decrease in cells in size.
Myocardial hypertrophy of the left ventricle of the heart is formed not only in various diseases, but also in absolutely healthy people with intense stress. Most athletes who engage in heavy physical work suffer from this disease.
There are many examples when such a pathology flowed into heart failure. Excessive physical activity leads to dangerous consequences, engaging in this kind of activity, due attention should be paid to the state of the heart muscle in order to avoid serious complications.
Causes and risk factors
Problems such as: thickening of the heart muscle can cause problems:
- Hypertension – in 90% of cases in people suffering from arterial hypertension.
- Heart defects – both congenital and acquired.
- Excessive physical activity.
- Psycho-emotional unstable states – stress, anxiety, excitement, etc.
- Sedentary lifestyle.
- Bad habits – alcoholism, smoking, drug addiction.
Varieties of pathology
The proliferation of muscle cells in the heart can cover the entire chamber or be located in various places. In most cases, it is localized on the septum between the ventricles, the aortic opening and the transition of the atrium to the left ventricle. At the location where an increase in muscle mass was formed, the following types of abnormal conditions are noted:
- Concentric left ventricular myocardial hypertrophy (it is also symmetrical) leads to a uniform thickening of the heart muscle. So that the ventricle can push blood into the opening of the main artery, the layer of its musculature progressively grows.
- Eccentric hypertrophy is formed mainly on the interventricular septum, in some cases, the side wall or in the apex is affected.
Depending on the effect on systemic circulation, the anomaly is divided into:
- Without obstruction of blood flow in the outflow tract. In such a situation, the effect on systemic circulation will be minimal. Often, the concentric form is not accompanied by obstruction, in contrast to the asymmetric variety.
- With obstruction. With a contraction of the ventricle, aortic orifice is compressed. Along with this, there is an additional barrier to normal blood flow, which increases hypertrophy to a greater extent.
Classification by muscle wall thickness:
- moderate hypertrophy is observed with a thickening of the heart muscle of more than 11 mm, but less than 21 mm;
- for an average degree, the thickness of the myocardium is 21–25 mm;
- pronounced LV pathology is characterized by a thickening of the muscle at the time of heart contraction of more than 25 mm.
Moderate changes in the myocardium of the left ventricle do not pose a threat to life. Often observed in people involved in physical labor or sports, performing an intense load.
Causes of increased myocardium in volume
The considered change in the heart muscle is for the most part a concomitant syndrome of various chronic heart diseases. The causes of LV hypertrophy are partly related to genetic defects, which means that the anomaly is inherited. The main causes of myocardial changes include:
- aortic valve stenosis;
- chronic stress;
- prolonged intense physical activity;
- hypertonic cardiopathy;
- essential arterial hypertension.
Often, the pathological condition of the heart occurs against the background of arterial hypertension. In most cases, an increase in myocardium in volume is due to exposure to high blood pressure.
Overweight is also a factor provoking the formation of cardiac pathology. An enlarged body needs a more intense blood supply, therefore abnormal changes in the heart muscle are formed.
Heart defects that impede the outflow of blood from the ventricle are a congenital predisposition to the formation of pathological changes in the myocardium. It is with genetic defects of the heart muscle that LV hypertrophy in a child is associated.
Causes of left ventricular hypertrophy
LVH therapy comes down to three points:
- Elimination of the symptoms of the problem.
- Improving health status.
- Prevention of relapse, disease progression.
Since in most cases, LVH is the result of arterial hypertension, then under the supervision of a doctor, such drugs are prescribed to the patient that can normalize his condition:
- ACE inhibitors – tablets “Lisinopril”, “Quadripril” and others. These drugs build pressure, and if you take them for a long time (at least six months), you can achieve normalization of the myocardial wall thickness.
- Beta-blockers – Metoprolol, Bisoprolol medicines. These pills reduce the load on the heart, reduce the heart rate.
- Means based on nitroglycerin. They are able to expand the vessels of the myocardium, thereby reducing the load on the muscle.
If the cause of the thickening of the wall is a heart defect, then get rid of the pathology by surgery. Moreover, it can take the form of:
- Aortic stenting.
- Prosthetics (heart transplant).
- Extraction of the part of the muscle that blocks the access of blood to the aorta.
Home methods only cope with LVH, which was caused by hypertension. You should resort to the help of non-traditional means after obtaining the approval of a doctor.
Among folk methods, one can distinguish such recipes:
- Hypericum medicine – per 100 g of dry grass 2 l of water. Boil the raw materials, boil for 10 minutes. Insist, add honey (200 g). Take 2 tablespoons per day for a month. St. John’s wort calms, cleanses blood vessels, prevents arrhythmia.
- Cranberry gruel. Grind fresh berries with honey or sugar. Take 1 tbsp. l after meal. Cranberries improves blood flow, restores vascular elasticity, reduces blood pressure, and has a general strengthening effect. It is advisable to make gruel daily to take the medicine fresh.
- Garlic based product. Grind the peeled cloves in the garlic. Add honey (1: 1 ratio). Put to insist in a dark place for 5-7 days, periodically shaking the contents of the jar. Use a tablespoon three times a day. Regular intake of garlic cleanses and strengthens blood vessels, helps eliminate arrhythmias, is useful for hypertension, heart failure.
- Decoction of blueberry shoots. Mix 10 g of raw material with 250 ml of water. Boil for 10 minutes, cool, strain. Take a tablespoon before each meal.
Left ventricular hypertrophy, the treatment of which is always necessary with the normalization of lifestyle, is often a reversible condition. It is important to give up smoking and other intoxications, reduce weight, correct hormonal imbalance and dyslipidemia, and optimize physical activity. In the treatment of left ventricular hypertrophy, there are two directions:
- Prevention of LVH Progression
- An attempt to remodel myocardium with a return to normal cavity sizes and thickness of the heart muscle.
Further, the main cause leading to hypertrophy is treated (correction of arterial hypertension and treatment of myocardiopathy).
- Beta-adrenergic blockers can reduce the load by volume and pressure, reduce myocardial oxygen demand, solve some of the problems with rhythm disturbances and reduce the risks of heart catastrophes – Atenolol, Metoprolol, Betolok-Zok, Nadolol.
- Calcium channel blockers become the drugs of choice for severe atherosclerosis. Verapamil, Diltiazem.
- ACE inhibitors are drugs that lower blood pressure and significantly inhibit the progression of myocardial hypertrophy. Enalapril, Lisinopril, Diroton are effective for hyperonia and heart failure.
- Sartans (candesartan, losartan, valsartan) very actively reduce the load on the heart and remodel the myocardium, reducing the mass of hypertrophied muscle.
- Antiarrhythmic drugs are prescribed in the presence of complications in the form of heart rhythm disorders. Disapiramide, Quinidine.
Signs of hypertrophy of the left heart are not always observed. A person may not even suspect the presence of such a problem. Improper development of the fetus during pregnancy often leads to the formation of defects and hypertrophy of a characteristic organ.
Such cases should be observed from birth to avoid severe complications.
Typical symptoms of this anomaly are:
- high level of pressure, poorly amenable to medical correction;
- interruptions in cardiac activity;
- shortness of breath, periodic attacks of suffocation, causeless intense cough in a supine position;
- fainting conditions;
- repeated pain attacks in the heart and behind the sternum;
- pressure instability;
- headaches of an obscure nature, drowsiness, general weakness;
- sleep disturbance;
- swelling of the face and limbs in the evening;
- blue nasolabial triangle and nail plate.
Even with minor symptoms of the analyzed problem and deterioration of well-being, you should immediately seek medical help for further diagnosis and therapy.
Concentric and eccentric left ventricular hypertrophy leads to the appearance of such characteristic clinical signs in a patient:
- burning chest pains;
- violation of the rhythm of the heart;
- severe swelling;
- heart failure;
- trophic changes in the fingers;
- fatigue and weakness;
- loss of consciousness;
- violation of normal functional activity.
Often physical activity is an impetus for the manifestation of symptoms of pathology.
The disease is characterized by a gradual increase in symptoms, followed by the development of acute heart failure, pulmonary edema, and fatal hemodynamic disorders. Especially pronounced signs of left ventricular hypertrophy become after physical or emotional stress. Symptoms of myocardial ischemia are associated with the compression of hypertrophied muscles of the vessels that feed the heart. As a result, patients may be diagnosed incorrectly for a long time.
Features of food
To strengthen the walls of the ventricle, as well as to restore the functioning of the myocardium, it is very important to follow a diet:
- Reduce salt intake. It increases pressure, and this can cause strokes and ischemia.
- Take seafood daily – squid, shrimp, mussels, oysters, fish. They improve the condition of blood vessels, reduce the likelihood of a heart attack.
- Eat fresh vegetables, fruits, and dried fruits regularly. Bananas, dried apricots, dates, figs, apples, plums, pomegranates – all these products make the vessels elastic, relieve cramps with arterial hypertension, and remove harmful cholesterol.
- Exclude smoked meats, fatty foods from the diet – it increases the risk of heart disease due to trans fats.
Patients need to eat fractionally, little by little, consume carrot juice, give preference to mashed cereals. Exclude spices and spices from the diet.
First of all, diagnostic measures are aimed at detecting diseases of the circulatory system. Only the attending specialist can make a correct diagnosis, so he collects the patient’s history (information about the presence of hereditary diseases, patient complaints).
The presence of endocrine diseases and congenital malformations in the family increases the likelihood of developing hypertrophy of the left heart. For a more complete diagnosis, the doctor prescribes the following procedures:
- laboratory blood tests (general and biochemical), study of hormonal status, urinalysis;
- X-ray examination of the chest organs, which determines the increase in the shadow of the heart and the shadow of the aorta;
- daily monitoring of ECG;
- Ultrasound of the heart before and after exercise;
- CT and MRI for more accurate determination of heart disease and associated abnormal changes;
In some cases, coronography is prescribed to assess coronary artery patency.
- Heart LVH is often recorded in patients aged 20-40 years.
- Women suffer from LVH less often than men.
- Thickening of the left ventricle with time and in the absence of treatment leads to an increase in the right atrium.
- A fatal outcome from this ailment occurs in 2–8% of cases.
- At the initial stage of hypertrophy, the patient has a favorable prognosis for recovery.
- It is important for patients to rest at least 7 hours a day, abandon products that lead to intoxication, slagging, constantly monitor blood pressure, and reduce physical activity.
Heart LVH is a dangerous pathology, because at first it may not manifest itself in any way and only on an ECG, ultrasound and MRI, a cardiologist will see changes in the work of the heart muscle. If the doctor finds LVH, then he will definitely begin to treat the patient: medically or surgically. Depending on the cause of the pathology and its severity. With timely contact with a cardiologist, the prognosis is favorable.
Tactics of treatment
Treatment of hypertrophy of the left heart is to affect the cause of the development of pathology. The treatment of altered myocardial tissues should be under the supervision of the attending physician. The main task is to reduce the size of the left ventricle to a normal volume.
First of all, you need to abandon addictions. Reduce salt intake, exclude fatty and fried foods from the daily diet.
If drug therapy did not give the expected results, then surgical treatment is used. The following surgical interventions are indicated:
- Morrow operation, which is a fragmented myocardial removal in the septum between the ventricles;
- replacement or transplantation of the aortic valve;
- mitral valve replacement;
- installation of a stent in the lumen of the coronary vessels;
- separation of adhesions at the mouth of the main artery.
Heart valve replacement
When the treatment for hypertrophy of the left heart does not bring the expected results, an pacemaker is introduced. This is a device designed to restore normal heart rate.
In general, for each patient, the treatment of the pathology under consideration is selected individually. All existing disorders of the heart, general condition and the presence of concomitant abnormalities are taken into account.
It is worth noting that timely detected hypertrophy is easier to correct. If the disease is not treated in the early stages, serious complications can arise, therefore, at the slightest manifestation of hypertrophy, it is necessary to seek the help of a cardiologist. The specialist will prescribe an adequate and competent therapy tactic that gives chances for a long life.
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