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Left ventricular hypertrophy


Disease: Left ventricular hypertrophy Left ventricular hypertrophy
Category: Cardiovascular diseases

Disease Definition:

Left ventricular hypertrophy is a condition in which the muscle tissue that makes up the wall of the heart's main pumping chamber (left ventricle) becomes enlarged (hypertrophy).


Some factors, such as high blood pressure that requires the left ventricle to work harder, could cause left ventricular hypertrophy. The walls of the chamber will grow thicker as the workload increases, and they will lose elasticity and might eventually fail to pump with as much force as a healthy heart.


Having left ventricular hypertrophy puts a person at risk of heart disease, including arrhythmia, heart failure, sudden cardiac arrest and heart failure.


Left ventricular hypertrophy (LVH) is more common in people who have high blood pressure or other heart problems. A person’s risk of LVH also increases with age.

Work Group:

Symptoms, Causes


Usually, LVH develops gradually. Particularly during the early stages of development, people may not notice any signs or symptoms. However, when signs and symptoms start occurring they may include:


  • Dizziness
  • Chest pain
  • Rapid exhaustion with physical activity
  • Shortness of breath
  • Fainting
  • Sensation of rapid, fluttering or pounding heartbeats (palpitations)


When one or more factors cause the heart to work harder than normal to pump blood to the body, LVH occurs. For instance if someone has high blood pressure, to counter the effect of the elevated blood pressure, the muscles of the left ventricle have to contract more forcefully than normal.


The heart will respond in the same way as other muscles to an increased workload. The muscle tissue in the walls of the left ventricle could become larger due to the work of adapting to high blood pressure. This increase in muscle mass causes the heart to function poorly. The workload on the heart is constant, which leaves only little time for the heart muscle to relax.


Some of the factors that could cause the heart muscle to work harder may include:

Aortic valve regurgitation:

This condition occurs when the heart valve that separates the left ventricle and the aorta doesn't close properly, which results in some blood flowing backward into the left ventricle. This condition will cause the volume of blood in the left ventricle to increase, which will require more force to pump it out.


High blood pressure is the most common cause of LVH. Millimeters of mercury (mm Hg) is the unit of measure with which a blood pressure reading is given. The blood pressure while the heart rests between beats is called diastolic pressure and the blood pressure while the heart contracts is called systolic pressure. A systolic pressure that is greater than 140 mm Hg and a diastolic pressure that is greater than 90 mm Hg, or 140/90 mm Hg is considered as high blood pressure.

Coronary artery disease:

In this condition, the arteries that supply blood to the heart muscle are obstructed. The heart will pump more forcefully if it doesn't receive enough blood.

Aortic valve stenosis:

The flap that separates the left ventricle from the aorta, the large blood vessel that delivers oxygen-rich blood to the body, is called the aortic valve. Aortic valve stenosis is the narrowing of the aortic valve. The left ventricle will work harder to pump blood into the aorta due to this partial obstruction.

Dilated cardiomyopathy:

In this condition, the left ventricle and sometimes other chambers of the heart become enlarged. Because the space inside the left ventricle is large, it will fill with more blood, which will cause the muscle to contract more forcefully to pump the blood out.

Heart attack:

Muscle tissue may become scarred or lost due to a heart attack. The surviving muscles may need to pump harder in order to compensate for this loss.


High blood pressure could be caused by obesity, which increases the body's demand for oxygen. These are factors that cause the left ventricle work harder.



Both the structure and the function of the chamber will be changed due to left ventricular hypertrophy:


  • The enlarged muscle will lose elasticity and become stiffened. This will prevent the chamber from filling properly and lead to increased pressure in the heart.
  • The enlarged muscle tissue will compress its own blood vessels (coronary arteries), restricting its own supply of blood.
  • The overworked muscle will become weak.


Some of the complications that could occur due to these problems may include:


  • Heart attack, which occurs when blood supply to the heart is interrupted
  • Heart failure, which occurs when the heart becomes unable to pump enough blood to the body
  • Sudden cardiac arrest, which is the sudden and unexpected loss of heart function, breathing and consciousness.
  • Arrhythmia, which is an abnormal heart rhythm
  • Ischemic heart disease, which occurs when the oxygen supply to the heart is insufficient.


Treating the underlying cause of the condition is what treatment for LVH will aim at. Treatment may include medication or surgery, depending on the cause.



Both medications and lifestyle changes, such as no smoking, regular exercise and a low-sodium, low-fat diet, are involved in treatment for high blood pressure.


There are some high blood pressure drugs that lower blood pressure, prevent further enlargement of left ventricle muscle tissue and even shrink the hypertrophic muscles. Some of the blood pressure drugs that could reverse muscle growth are:

Thiazide diuretics:

Usually, these are the first, but not the only, choice in high blood pressure medications. Thiazide diuretics work on the kidneys to help the body in eliminating sodium and water, and thus reduce blood volume.

Calcium channel blockers:

Some examples of these drugs include nifedipine, amlodipine, verapamil and diltiazem. These medications prevent calcium from entering cells of the heart and blood vessel walls, which lowers blood pressure.

Beta blockers:

Some examples of these drugs include bisoprolol, carvedilol and metoprolol. These medications slow the heart rate, reduce blood pressure and prevent some of the harmful effects of stress hormones.

ACE (angiotensin-converting enzyme) inhibitors:

These medications improve blood flow and decrease the workload on the heart by widening or dilating blood vessels. Some examples are captopril, enalapril and lisinopril. In some people, these medications could cause an irritating cough. However, to gain the benefits of the medication, it's best to put up with the cough. This problem could be discussed with a doctor. A person could switch to another ACE inhibitor or an angiotensin II receptor blocker.

ARBs (angiotensin II receptor blockers):

These medications have many of the beneficial effects of ACE inhibitors; however, they don't cause a persistent cough. People who can't tolerate ACE inhibitors could use these medications. Some examples include valsartan and losartan.



In case aortic valve stenosis is the cause of LVH, the narrowed valve could be surgically removed and replaced with either an artificial valve or a tissue valve from a human-cadaver donor, pig or cow. In case someone has aortic valve regurgitation, they could have surgery to repair or replace the leaky valve.


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