What is Left Ventricular Hypertrophy (LVH)?
Left ventricular hypertrophy (LVH), also known as an enlarged heart, is a condition in which the muscle wall of heart’s left pumping chamber (ventricle) becomes thickened (hypertrophy).
Other conditions, such as heart attack, valve disease and dilated cardiomyopathy, can cause the heart (or the heart cavity) to get bigger. This is not the same as LVH.
Symptoms and Causes
What causes LVH?
The heart is a muscle. And so, like other muscles, it gets bigger if it is worked hard over time. Several health conditions cause your heart to work harder than normal. The most common cause of LVH is high blood pressure (hypertension). Other causes include athletic hypertrophy (a condition related to exercise), valve disease, hypertrophic cardiomyopathy (HOCM), and congenital heart disease.
What are the symptoms of LVH?
Some patients have no symptoms related to LVH. The condition usually develops over time, and most symptoms occur when the condition causes complications. The most common symptoms of LVH are:
- Feeling short of breath
- Chest pain, especially after activity
- Feeling dizzy or fainting
- Rapid heartbeat, or a pounding or fluttering sensation in your chest
Diagnosis and Tests
How is LVH diagnosed?
Left ventricular hypertrophy may be first noticed on an electrocardiogram (EKG). If your doctor sees evidence of LVH on your EKG, you will have an echocardiogram to determine if you have the condition.An echocardiogram is the most common way to determine if a patient has LVH. This test allows your doctor to measure the walls of the ventricle. A measurement greater than 1.5 cm is considered enlarged. Patients with athletic hypertrophy usually have a measurement less than 1.5 cm, and the wall returns to normal size after exercising. If you do not have any of the typical causes of LVH and have a family history of HOCM, your doctor may determine that you have HOCM.
Management and Treatment
How is LVH treated?
If you have LVH, your treatment depends on the cause of the condition:
- Hypertensive LVH (caused by high blood pressure) is treated by controlling your blood pressure. This is done with lifestyle changes and medications, when needed. There is ongoing debate about whether some medications for high blood pressure can cause LVH to improve.
- Athletic hypertrophy does not require treatment. If you have this condition, you will need to stop exercising for 3 to 6 months. At that time, you will have another echocardiogram to measure the thickness of the heart muscle and see if it has lessened.
- HOCM is a rare condition that should be followed by a cardiologist with expertise in this area. If you have HOCM, you may need medical management or surgery.
If you have LVH, it is important to get proper treatment. Although the condition can be well-managed, you are at risk of developing heart failure. Following your treatment plan and seeing your doctor as recommended can help reduce this risk.