Left ventricular hypertrophy treatment, causes, diagnosis

gipertrofiya miokarda6 - Left ventricular hypertrophy treatment, causes, diagnosis

The mechanism of myocardial hypertrophy is quite simple. Everyone knows that the heart performs “pumping” functions, pumping all the blood in the body, delivering oxygen to each organ. Constant excessive physical and emotional stress leads to an increased need for all organs in oxygen and, consequently, to a large volume of blood. All this leads to the fact that the myocardium does not cope with the work, loses its elasticity and increases in size.

Myocardial hypertrophy usually occurs for the following reasons: – arterial hypertension; – acquired and congenital heart defects; – impaired blood supply; – obesity; – constant congestion on the heart; – genetic predisposition .

It should also be noted that children are most often affected by myocardial hypertrophy and this disease is a sign of congenital heart disease.

Any doctor begins any diagnosis with an external examination of the patient and his questioning (history taking). As soon as the slightest suspicion of a heart pathology arose, the patient was immediately sent for a cardiological examination.

The most reliable way to diagnose myocardial hypertrophy is an echocardiogram, two-dimensional echocardiogram, Doppler echocardiography, magnetic resonance imaging, positron emission tomography.

Hypertrophy of the heart, or, in other words, hypertrophic cardiomyopathy is a thickening of the wall of the left ventricle of the heart, which leads to malfunctioning of the aortic valve. The problem is common among hypertensive patients, as well as athletes, people with a sedentary lifestyle, addicted to alcohol and those who inherited a tendency to pathology.

Myocardial hypertension of the left ventricles of the heart belongs to class 9 on the ICD 10 scale, together with other diseases of the circulatory system. This pathology is mainly a syndrome of other heart diseases, the indirect signs of which are manifested. In order to prevent possible problems in the future, it is necessary to intensively treat a hypertrophied organ in a timely manner, immediately after the detection of pathologies.

Depending on the signs of LVH and the size of the deformed muscle tissue, several stages of the development of the disease can be distinguished:

Moderate left ventricular hypertrophy (LVH) occurs as a result of hypertension or other heart diseases. This seemingly insignificant increase signals a heart overload and that the risk of myocardial diseases (heart attack, stroke) for the patient increases. It often proceeds without any signs, it is detected only when analyzing the ECG. If the left ventricle is enlarged, it is necessary to be treated with the help of specialists, best of all – stationary.

Pronounced LVH is characterized by dystrophic changes, in which the mitral valve is located close to the surface of the septum and interferes with the flow of blood, causes excessive muscle tension and stress on the left ventricle.

The causes of left ventricular hypertrophy of the heart can be varied, among them both chronic and acquired diseases of different parts of the body:

  • hypertension;
  • obesity: the development of an ailment in young children who are overweight is very dangerous;
  • ischemia;
  • diabetes;
  • arrhythmia, atherosclerosis;
  • frequent excessive physical exertion;
  • alcoholism, smoking;
  • high blood pressure;
  • lung diseases;
  • aortic stenosis;
  • abnormalities of the mitral valve;
  • stress, psychological illness, nervous exhaustion.

The development of the body in a child can occur with a violation of the processes of myocardial repolarization and, as a result, an increase in the walls of the ventricle. If such a situation arose, it must be prevented, and in the future to observe stationary during adulthood and not allow progression. Continuous exercise can naturally lead to heart enlargement, while work related to weight lifting is a potential threat to systolic overload, so you should normalize your physical activity and monitor your health.

Another indirect reason is sleep disturbance, in which a person stops breathing for a short period of time. It can be observed in women during menopause or in the elderly and entails consequences such as expansion of the diameter of the vessels of the heart, growth of the septum and walls of the heart, increased blood pressure, arrhythmia.

If the left ventricle is hypertrophied – this is not a disease, but it can provoke a lot of them in the future, including death of heart attacks, strokes, angina pectoris and other heart ailments. Often, organ enlargement occurs due to an active lifestyle, in athletes, when the heart works harder than in the average body. Such changes may not pose a threat, but in each case, qualified consultation and advice from a doctor is necessary.

Diagnosis of left ventricular hypertrophy occurs in several ways: this is the detection of signs of the disease on the ECG, examination of the heart by ultrasound or using a magnetic resonance imaging scanner. If you have any heart problems and symptoms of the disease, you should contact a cardiologist, and if you have already suffered a defect and suspect complications, you need a cardiac surgeon and, possibly, a treatment system.

ECG – a common diagnostic method, helps to know the thickness of the heart muscle and voltage signs. Nevertheless, it is difficult to detect LVH on an ECG without the participation of other methods: an erroneous diagnosis of hypertrophy can be made, since ECG symptoms that are characteristic of it can also be observed in a healthy person.

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LVH on ultrasound

An ultrasound study is more likely to judge the individual factors and causes of hypertrophy. The advantage of ultrasound is that this method allows not only to diagnose, but also to determine the features of the course of hypertrophy and the general condition of the heart muscle. Indicators of cardiac echocardiography reveal such changes in the left ventricle as:

  • ventricular wall thickness;
  • the ratio of myocardial mass to body weight;
  • coefficient of asymmetry of seals;
  • direction and speed of blood flow.
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Heart MRI

Magnetic resonance imaging helps to clearly calculate the area and degree of enlargement of the ventricle, atrium or other compartment of the heart, to understand how strong the dystrophic changes are. Myocardial MRI shows all the anatomical features and the configuration of the heart as if “stratifying” it, which gives the doctor a complete visualization of the organ and detailed information about the condition of each department.

Many people are prone to heart hypertrophy. If the problem is severe, drug or surgical treatment of left ventricular hypertrophy is performed. Moreover, depending on the degree of damage, treatment can be aimed at preventing the progression of the disease or returning the myocardium to normal size boundaries. But it happens that this condition is reversible, if the ailment cannot be completely cured, then regression can be achieved by correcting such things as:

  • Lifestyle;
  • type of food;
  • hormonal balance;
  • excess weight;
  • amount of physical activity.

Medicines for hypertrophy of the left ventricle of the heart can have an effective result if taken under the supervision of a doctor. It is impossible to completely eliminate the symptoms of hypertension, however, taking antihypertensive drugs with this disease and following a diet will help to deal with the causes and prevent health deterioration. To cure LVH, prescribe these drugs:

Verapamil is an angiarrhythmic agent from the group of calcium channel blockers. Reduces myocardial contractility, reduces heart rate. It can be used by both adults and children, the doses are set individually.

Beta-blockers – reduce the load of pressure and volume in the heart cavity, help to even out the rhythm and reduce the risk of defect.

Sartans – effectively reduce the overall load on the heart and remodel the myocardium.

Myocardial hypertension of the lying heart belongs to class 9 on the ICD-10 scale, along with other diseases of the circulatory system. Preference should be given exclusively to drugs whose quality has been tested and proven clinically, experimental drugs can not only not have the expected effect, but also adversely affect overall health.

Surgery for left ventricular hypertrophy may be needed to remove a hypertrophied muscle area in the late and advanced stages of the disease. For this, a transplant of the whole heart or its individual parts is carried out. If the cause of LVM is damage to the valve or septum, an attempt is first made to transplant specifically these organs, which is simpler than whole heart surgery.

Treatment of left ventricular hypertrophy of the heart with folk remedies cannot help in the late stages of lesions, but it can be effective with slight increases to prevent their development and reduce the risk of more serious consequences. You can not completely cure the ailment, but traditional medicine can relieve discomfort, chest pain, weakness and fainting. Known tools are:

Herbal preparations as adjunctive therapy for the main treatment (blueberries, motherwort, marshmallow hawthorn, horsetail, cornflower flowers, adonis)

Infused milk: boil and pour overnight in a thermos, or put in the oven until a brown crust forms.

Lily of the valley in the form of drops of tincture or gruel. For tincture, pour lily of the valley with vodka or alcohol, insist in a dark place for 2 weeks, take 10 drops 3 times a day for 2 months. Porridge: pour lily of the valley flowers with boiling water, insist 10 minutes. Then drain the water, grind the plant and take a tablespoon 2 times a day. It is recommended in combination with drops.

Garlic honey: crushed garlic mixed with honey in the proportions 1: 1, insist a week in a dark place, take 1 tablespoon 3 times a day before meals.

Dry red wine infused with dried rosemary. Pour the leaves with wine, leave for about a month in a dark place, strain and take before eating.

Cranberries, mashed with sugar: a teaspoon 4 times a day.

Pathological myocardial hypertrophy

This disease is often asymptomatic and people can live for years without even suspecting that they have myocardial hypertrophy. It is detected, as a rule, completely by accident during a planned or unscheduled medical examination.

Signs of myocardial hypertrophy are as follows: – shortness of breath during physical and emotional stress; – occasional, inexplicable fainting; – short-term heart pains (as with angina pectoris); – cardiac arrhythmia .

The goal of the treatment of myocardial hypertrophy is to reduce the size of the ventricle of the heart. To solve this problem, a comprehensive approach is required, which is reflected in lifestyle changes, rejection of bad habits: – eliminate foods high in animal fats from your diet to the maximum; – stop smoking and abuse alcohol

– eliminate violations in the structure of our DNA, which is the real cause of diseases; – strengthen our immune system against diseases of the heart and blood vessels; – play the role of carriers of “immune memory”, recording all the information about foreign elements that our body had to deal with and methods their neutralization.

These properties of this immunomodulator make it the most effective in the world, so its help is required not only for the complex treatment of myocardial hypertrophy, but also for any diseases of the heart and blood vessels.

Myocardial hypertrophy, the treatment of which we examined above, is not really a “sentence”. With an appropriate lifestyle, anyone can completely get rid of this disease and not think about it, but receiving an immunomodulator is simply necessary.

If ventricular hypertrophy is detected on an ECG, then different treatment options are selected depending on the stage of the disease.

To eliminate the cause of the violation, get rid of the symptoms of hypertrophy and increase the patient’s life expectancy, appropriate drugs are selected.

These goals are achieved by:

  1. Beta-blockers. With their help, it was possible to improve the condition of most of the patients. After the penetration of the active component into the body, there is a decrease in myocardial oxygen demand. Under conditions of psychoemotional and physical stress under the influence of drugs, the effect of the sympathoadrenal system on the heart decreases. This reduces the severity of symptoms and helps to improve the quality of life of the patient.
  2. Calcium channel blockers. Under their influence, it is possible to improve the contractility of the organ and reduce the rate of development of hypertrophic changes. During treatment, it is possible to reduce the oxygen demand of the myocardium.
  3. Additional drugs like antiarrhythmic drugs, anticoagulants, antihypertensive drugs, vitamins and minerals.
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If the right ventricle begins to thicken, then this indicates a malfunction of the lungs. Therefore, in these cases, resort to drugs to improve the respiratory system.

Ventricular hypertrophy in severe cases requires surgical intervention. This method is resorted to if conservative methods are ineffective.

Such therapy consists in excising hypertrophic sites. In case of serious damage, transplantation of a donor organ is required.

Very often, with such changes, a stent is placed in the coronary arteries, angioplasty is performed, adhesions are dissected, and valves are prosthetized.

With prolonged work of the myocardium under load, which is constantly increasing, a pathological form of hypertrophic cardiomyopathy occurs. A hypertrophied heart must adapt to new conditions. The myocardium thickens rapidly. In this case, the following occurs:

  • blood supply disturbance;
  • the effect of nerve tissue on metabolic processes changes;
  • growth of nerves and capillaries lags behind;
  • myocardial structures wear out;
  • violation of repolarization;
  • systolic, diastolic dysfunction appears.

The main goal of treatment is to restore the previous size of the myocardium. The procedures that are aimed at this are carried out in a complex. More likely to cure hypertrophy if an early diagnosis has been performed. An important part in the myocardial treatment system is lifestyle. Doctors recommend following these rules:

  • stop smoking;
  • follow a diet;
  • reduce weight;
  • limit salt intake;
  • exclude drugs;
  • give up alcohol.

Treatment of left ventricular myocardial hypertrophy with a medication method includes taking medications that:

  • correct heart rhythm disturbance (antiarrhythmics);
  • reduce pressure – angiotensin receptor antagonists, ACE inhibitors;
  • drugs with negative ionotropic effects relax the heart – calcium antagonists from the verapamil group, beta blockers;
  • increase muscle strength – ionotropics;
  • liquid withdrawn – diuretics;
  • with the threat of infectious endocarditis – antibiotic prophylaxis.

The doctor must select the drugs without fail. Self-medication is unacceptable and fraught with serious consequences.

What to do in the case of this pathology? An effective method of treatment that will allow you to change the contractions of the ventricles and the course of arousal is a two-chamber pacemaker. In more complex cases, with asymmetric hypertrophy of the MJP, latent obstruction, the absence of the effect of the drug, help to save the patient’s life:

  • pacemaker implantation;
  • excision of the share of the interventricular septum;
  • defibrillator installation;
  • transortic septal myectomy;
  • transcatheter septal alcohol ablation.

Everything will depend on the degree of development of the pathology and the condition of the patient himself. We examined the symptoms and treatment of left ventricular myocardial hypertrophy.

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.
  • decreases obstruction at the exit of the left ventricle
  • patient’s life expectancy is increasing
  • rhythm disturbances, fainting, angina pectoris do not develop
  • heart failure does not progress
  • quality of life improves.

Thus, left ventricular hypertrophy should be suspected, diagnosed and corrected as early as possible. This will help to avoid serious complications with reduced quality of life and sudden death.

Diagnosis of the disease in athletes

The formation of myocardial hypertrophy in athletes is almost imperceptible. As a result of increased physical exertion, the heart begins to pump more and more blood, and the muscles begin to grow in size. Hypertrophy is very dangerous, since in the absence of symptoms and complaints there is a heart attack, stroke, sudden cardiac arrest. In order not to cause any complications, you can not abruptly quit playing sports.

Hypertrophy in athletes has three types:

  • Concentric hypertrophy – the myocardium increases, the cavity of the ventricles remains unchanged. Occurs in static sports and games.
  • Eccentric hypertrophy is a proportional change in muscle. Characteristic for dynamic sports (long-distance running, skiing, swimming).
  • Mixed hypertrophy – sports activities, which simultaneously use immobility and dynamics (bicycle, rowing, ice skating).

Signs of left ventricular hypertrophy

Symptoms of cardiomyopathy are not always obvious, often people are unaware of a problem. If the fetus did not develop correctly during pregnancy, there may be a congenital malformation and hypertrophy of the left heart. Such cases must be observed from birth and avoid complications. But if periodic interruptions occur in the work of the heart and a person feels any of these signs, it is possible that the walls of the ventricle are not in order. The symptomatology of this problem is as follows:

  • labored breathing;
  • weakness, fatigue;
  • pain in the chest;
  • low heart rate;
  • swelling of the face in the afternoon;
  • disturbed sleep: insomnia or excessive drowsiness;
  • headache.

Hypertrophy of the right atrium

Thickening of the walls of the right ventricle is not a disease, it is an abnormality that occurs with overloads in this area. This happens as a result of the receipt of a large volume of venous blood from large vessels. These reasons may include:

  • stenosis;
  • congenital malformations;
  • obesity;
  • defects of the atrial septum, in which blood simultaneously enters the right and left ventricle.

With hypertrophy of the right ventricle, these symptoms appear:

  • dizziness;
  • pain in the chest;
  • hemoptysis;
  • fainting;
  • shortness of breath without exertion;
  • bloating;
  • signs of heart failure – enlarged liver, swollen legs;
  • arrhythmia;
  • night cough;
  • malfunction of internal organs;
  • heaviness in the hypochondrium;
  • cyanosis of the skin;
  • enlarged veins on the stomach.

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.