Left ventricular hypertrophy - signs of ECG

Cardiac ventricular hypertrophy or cardiomyopathy is an increase in muscle heart mass, a dangerous condition that increases the risk of death. The body reacts to high blood pressure. But in general, for this kind of change, the prognosis can be favorable, because there are many different modern treatments.

Causes of ventricular hypertrophy

As a rule, the term myocardial hypertrophy, means an increase in the left or right, as well as both ventricles. Any physical activity, bad habits, for example, overeating, smoking are undesirable for the heart. From the first minutes of birth, the heart must withstand a certain load and the strength of this important organ depends on the state of myocardial tone, that is, the heart muscle.

With a large load on the heart requires a lot of blood, which means more heart rate. Each contraction of the heart is the transmission of a certain amount of blood through the atrium and ventricles. The heart functions like a distillation pump. A pressure is created that promotes the transfer of blood from the atria to the ventricles, then to the aorta, after which the entire circulatory system is filled.

Loads lead to the fact that the amount of blood exceeds the norm, the heart begins to work faster, because you need to cope and pump a large amount of blood, supplying it to all parts of the human body. The ventricles of the heart must have time to throw out any mass of blood into the aorta, and if the heart is not able to work in such a rhythm, then the myocardium loses its elastic properties and increases in volume.

Constant pathological process contributes to the growth of myocardial hypertrophy. Not only hypertension, but also congenital or acquired heart defects, myocardial blood supply failure, overweight or excessive exercise can provoke hypertrophy. Also among the reasons doctors note hereditary predisposition.

The increase in the ventricle of the heart occurs in people of different age categories, but most often this affects children. Hypertrophy of the heart occurs in newborns, this is due to the fact that the right side of the heart has a large load.

But most often, ventricular hypertrophy indicates a congenital heart disease, manifested in violation of the outflow of blood from the right ventricle. Also among the reasons there is a change in the interventricular septum, leading to a situation where both sections communicate with each other, while the blood is poorly saturated with oxygen.

Replacing the lack of nutrition of organs, the heart works hard, causing hypertrophy. Often, an increase in pressure in the pulmonary artery causes hypertrophy. From this and there are dizziness, shortness of breath and multiple fainting. Another factor in the emergence of this pathology is stenosis of the valve of the lungs.

Signs and symptoms of ventricular hypertrophy

Myocardial hypertrophy is insidious, it can not be detected for a long time. People live with such a problem for years without even knowing it. The diagnosis is made at a random or scheduled medical examination or during an autopsy after the death of the person.

Many people with myocardial hypertrophy experience pain in the heart, resembling angina in symptoms, fainting occurs with them, dyspnea occurs during physical actions, and heart rhythm failure.

Diagnosis of ventricular hypertrophy

For the diagnosis of cardiomyopathy, an echocardiogram, the calculation of a special index determining the degree of hypertrophy, a two-dimensional echocardiogram, magnetic resonance imaging, Doppler echocardiography, positron emission tomography are used. During treatment, the patient’s condition is monitored mainly with an electrocardiogram.

Treatment of ventricular hypertrophy

In the treatment of the main task is to reduce the size of the ventricle of the heart. To solve the problem, an integrated approach is needed. In addition to drug therapy, it is necessary to change the habitual way of life that caused the disease. The elimination of the phenomenon of myocardial hypertrophy is possible in the process of applying highly effective, modern drugs. Their healing properties allow the heart muscle to return to normal.

In severe cases, surgery is performed to remove part of the hypertrophied muscle. Changing the lifestyle of patients, it is important, they are recommended to consult specialists of rehabilitation therapists and nutritionists. Patients who want to be healthy and at the same time are overweight are prescribed an individual diet.

The treatment will be successful if you can overcome bad habits, reduce salt intake, stop drinking alcoholic beverages, eliminate foods that kill the body with cholesterol, remove smoked and fried foods from the menu.

Expert Editor: Pavel Alexandrovich Mochalov | D.M.N. general practitioner

Education: Moscow Medical Institute. I. M. Sechenov, specialty - “Medicine” in 1991, in 1993 “Occupational diseases”, in 1996 “Therapy”.

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What is left ventricular hypertrophy

Cardiac hypertrophy, or, in other words, hypertrophic cardiomyopathy, is a thickening of the wall of the left ventricle of the heart, which leads to malfunction of the aortic valve. The problem is common among hypertensive patients, as well as athletes, people leading a sedentary lifestyle, alcohol addicts and those who inherited a tendency to pathology by inheritance.

Hypertension of the myocardium 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 basically a syndrome of other heart diseases, the indirect signs of which manifests. In order to prevent possible problems in the future, it is necessary to intensively treat the hypertrophied organ in a timely manner, immediately after the detection of pathologies.

The degree of left ventricular hypertrophy

Depending on the signs of LVH and the size of the deformed muscle tissue, there are several stages in the development of the disease:

Moderate left ventricular hypertrophy (LVH) occurs as a result of hypertension or other heart diseases. This insignificant increase at first glance signals an overload of the heart and that the risk of myocardial diseases (heart attack, stroke) for the patient increases. Often proceeds without any signs, is found only in the analysis of the ECG. If the left ventricle is enlarged, it is necessary to be treated with the help of specialists, the best of all - permanently.

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

Increase in the left ventricle of the heart - causes

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 illness in very young children who are overweight is very dangerous,
  • ischemia,
  • diabetes,
  • arrhythmia, atherosclerosis,
  • frequent excessive exercise
  • alcoholism, smoking,
  • high blood pressure,
  • lung diseases
  • aortic stenosis,
  • disorders of the mitral valve,
  • stress, psychological diseases, nervous exhaustion.

The development of an organism in a child can proceed in violation of the processes of myocardial repolarization and, as a result, an increase in the walls of the ventricle. If such a situation has arisen, it must be prevented, and further observed permanently during adulthood and to prevent progression. Regular exercise can naturally lead to expansion of the heart, while work associated with weight lifting is a potential threat of systolic overload, so you should normalize your physical activity and monitor your health.

Another indirect cause 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 older people and entails such consequences as expansion of the diameter of the heart vessels, growth of the septum and walls of the heart departments, high blood pressure, arrhythmia.

Signs of left ventricular hypertrophy

The symptoms of cardiomyopathy are not always obvious, often people are unaware of the problem. If during pregnancy the fetus developed abnormally, there may be a congenital defect and hypertrophy of the left heart. Such cases must be observed from birth and to avoid complications. But if there are periodic interruptions in the work of the heart and the person feels any of these signs, it is possible that the ventricular walls are not in order. The symptoms of this problem are:

  • labored breathing,
  • weakness, fatigue,
  • chest pains
  • low pulse
  • swelling of the face in the afternoon,
  • disturbed sleep: insomnia or excessive sleepiness,
  • headache.

What it is?

Before all the planned issues are considered, it is necessary to find out what the left ventricular hypertrophy means. Having understood the essence of pathology, it will be easier to get acquainted with its features, causes, methods of treatment and diagnosis.

The essence of this pathology is to increase the thickness of the muscle layer in the left ventricle. Normal values ​​do not exceed 11 mm. When the thickness of the muscle layer is more than 12 mm. already there is a moderate left ventricular hypertrophy. The disease is equally common in people of different ages. It is quite common.

Complete cure is possible only through surgery. But it is not assigned to all patients with such a diagnosis, but only to those people who have the threat of life. In most cases, conservative treatment is prescribed, which allows to reduce the pathological manifestation or to keep it at a constant level.

Causes of illness

There are many factors that can provoke the development of LVH. The basis of the development of pathology are the factors due to which the left ventricle shrinks intensively. Under such circumstances, muscle wall growth occurs. In the role of such factors can be various kinds of pathology or high load on the heart.

Hypertrophy, which extends to the left ventricle, is often diagnosed in professional athletes. During a sports career, they regularly expose their bodies to excessive aerobic exercise. With such a lifestyle, the muscular wall is forcedly pumped and thickened. Another reason is overweight. In such people, the heart is constantly experiencing a high load, which makes it work in an enhanced mode.

Now consider the diseases that often become causes of left ventricular hypertrophy of the heart:

  • hypertrophy, which has grown into a chronic condition in which pressure values ​​are above 145 per 100,
  • narrow aortic valve,
  • atherosclerosis of the aorta.

The disease is not always acquired, there are also congenital pathologies.

Pathology is divided into species. The basis of separation are various factors. For example, by severity, there are three varieties:

  • moderate form is characterized by an increase in the muscular layer up to a maximum of 2 cm, the treatment is easy, and there is no threat to life, for the most part it is typical for athletes,
  • the middle form is characterized by an increase in the tissue of the left ventricle to 2.5 cm,
  • severe degree is diagnosed in cases where the thickness of the muscle layer exceeds 2.5 cm.

Another classification is based on the location of the thickening:

  1. Concentric hypertrophy of the left ventricle is characterized by expansion of the myocardium and a decrease in the cavities of the heart muscle. The left ventricle usually expands. This form of the disease affects people over 35 years old.
  2. The eccentric hypertrophy of the left ventricle has opposite characteristics (cavities increase, and walls expand). At risk are people after 30 years, mostly men. The cavity of the left ventricle is very large. People with this pathology complain of severe heart pain. With the reduction of loads, the process of increasing the muscle layer decreases.
  3. Obstructive or mixed form is also called cardiomyopathy. The shape of the ventricle in this form of the disease resembles an hourglass. Thickening affects the walls of the cavities and myocardium. This disease manifests itself in young people who are under 35 years old.

How to suspect a disease

The symptomatology of this disease is heterogeneous, which makes its identification problematic. In some people, the pathology of the heart does not manifest itself in any way, and they live in peace without knowing it. There are also cases when the symptoms of left ventricular hypertrophy have a significant effect on a person's well-being. The most common signs of the disease include the following:

  • angina develops against the background of compression of the vessels that are responsible for nourishing the heart, this sign of left ventricular hypertrophy is displayed on the ECG and is felt even without examination,
  • atrial fibrillation
  • loss of consciousness occurs as a result of heart sinking for a few seconds,
  • atrial fibrillation,
  • myocardial starvation
  • dyspnea,
  • increase or violation of blood pressure, instability of indicators,
  • headaches and poor sleep,
  • weakness, fatigue, loss of well-being,
  • chest pain.

Any of these conditions should be the impetus for visiting the doctor. You can not wait until the symptoms pass by itself. She necessarily has a cause that can lead to irreparable consequences.

If not treated

In itself, the disease in moderate form is not dangerous and does not pose a threat to human life. But against its background a whole series of diseases can develop, each of which has a serious impact on health and well-being. Therefore, it is necessary to engage in the treatment of LVH, despite the lack of symptoms and changes in health.

If left untreated, heart diseases of various kinds can develop with a high degree of probability, among which the following diseases are the most dangerous:

For any of these afflictions, an attack can cause cardiac arrest and death. You know, that the hypertrophy of the left ventricle of the heart is dangerous, and now nobody will doubt that this disease is in danger, it means that you can proceed to consider treatment methods.

Treatment methods

Only a cardiologist can tell how to cure left ventricular hypertrophy. He must have the data obtained as a result of a complete diagnosis. The choice of treatment is influenced by the nature of the disease, the causes of its occurrence, the characteristics of the development and the accompanying pathologies.

Conservative Therapy: Medicines

In the course of treatment, various drugs can be prescribed, each of which has a different effect on the body and allows you to achieve the corresponding effect.

  1. Acceptance of "Verampil" with beta-blockers will allow to remove unpleasant and painful symptoms, improve overall well-being.
  2. Drugs that help to normalize blood pressure and reduce the heart rate.
  3. ACE inhibitors block the development of hypertrophy. Taking these drugs over time allows you to reduce symptoms and prevent the development of the disease.
  4. Antihypertensive drugs improve the nutrition of the myocardium and contribute to the normalization of heart rhythm.

Only surgery can completely rid a person of LVH. If the disease has occurred against the background of a heart defect, then the operation cannot be avoided, moreover, it should be done without delay. Three types of surgical treatment are practiced:

  1. Prosthetics on the aortic valve should be performed against the background of its narrowing. The operation is vital. According to statistics, without surgery, 95% of patients live no more than 5 years with such a diagnosis.
  2. Aortic stenting is performed when aortic atherosclerosis is diagnosed. The operation is prescribed when the vessel is narrowed by an atherosclerotic plaque by more than 50%. With lower rates of narrowing of the artery, the treatment is of a medicinal nature.
  3. With a strong manifestation of hypertrophy resorted to excision of excess muscle tissue.

Lifestyle and Diet

Regardless of the form of the disease, its degree and adherence to medical tactics, it is necessary to change your lifestyle and follow a special diet. Such actions will increase the effectiveness of treatment and increase the ability of the heart to resist the disease.

When diagnosing LVH, it is necessary to change the lifestyle in accordance with the following recommendations:

  • complete rejection of all bad habits
  • normalization of weight,
  • regular exercise physiotherapy, especially it is necessary for people with sedentary / sedentary lifestyle,
  • reduction of stress factors
  • decrease in physical activity.

The diet will also have to be adjusted:

  • split meals (6 times a day in small portions),
  • reducing the amount of salt
  • refusal of smoked food, fatty and fried foods,
  • inclusion in the daily diet of dairy and dairy products,
  • seafood and lean meat,
  • fruits and vegetables should be included in the daily diet,
  • sweets to exclude or reduce to the minimum possible.

Folk remedies

Treatment of folk remedies left ventricular hypertrophy is rarely used. The most common are plants that have an antioxidant and calming effect on the body. It is also recommended to receive decoctions from plants that strengthen vessels and free the body from plaques. You can take vitamin complexes and dietary supplements, which contain potassium and calcium, omega, magnesium and selenium.

Any folk remedy can only be used as an additional method of treatment. The choice of prescription must be agreed with the doctor. Below will be described the recipes that are used most often for LVH:

  1. We make a collection of 3 spoons of motherwort, 2 tablespoons of dried eggs and wild rosemary, spoons of kidney tea. One tablespoon of this collection pour 1.5 cups of warm water. Bring to a boil and keep on fire for 5 minutes. Insist decoction 4 hours. Filter and take three times a day before meals in a warm form.
  2. Grind fresh cranberries with sugar. Take it in this form should be three times a day after eating a teaspoon.
  3. To prepare a decoction of young shoots from blueberry bushes, you must take a tablespoon of crushed sprouts and cook them in a glass of water for 10 minutes. The cooled and filtered decoction is taken three times a day in a tablespoon.

Complications and prognosis

With timely detection of the disease and compliance with the prescribed treatment, the prognosis will be positive. Moreover, in some cases, treatment is not even prescribed. For example, with minimal thickening of the ventricular wall and the absence of associated pathologies. Such situations are more typical for athletes.

The disease in its advanced form, to which other problems with the heart and blood vessels are attached, is likely to cause the development of dangerous pathologies:

  • angina pectoris, which is accompanied by frequent pain,
  • dangerous arrhythmias,
  • myocardial infarction.

According to statistics, only 4% of patients die. This allows LVHL to be attributed to non-dangerous diseases. But this concerns only the early form of the disease.

Only timely diagnosis and effective treatment can save the heart from the development of dangerous pathologies. If you experience any of the symptoms described above, you should consult a specialist as soon as possible. This will help save the heart from the development of dangerous ailments that may put a person’s life at risk.

Types of right ventricular hypertrophy

Classification of pathology is based on the features of the clinical course of the disease. Cardiologists distinguish several types of hypertrophy:

  1. Pronounced - in this situation, the mass of the right ventricle greatly exceeds this parameter for an element that starts a large circle of blood circulation.
  2. Classic - is characterized by an increase in the size of the right ventricle, but its mass is inferior to the same parameter on the left side. Excitation in this zone has a higher duration.
  3. Moderate - accompanied by a slight external increase in the right ventricle, but its weight is less when compared with the left.

Given the time of onset of symptoms of pathology, hypertrophy can be congenital or acquired. The first form of anomaly is detected in newborn babies. It can also be diagnosed during pregnancy. Different diseases result in the acquired form of right ventricular hypertrophy.

Hypertrophy of the myocardium of the right ventricle is the result of a number of factors. They are cardiogenic or non-cardiogenic. The main reasons are the following:

  1. Emphysema. Under this term understand the pathological expansion of the alveoli and the surrounding respiratory tract.
  2. Mitral stenosis. In such a situation, the opening is narrowed, which prevents the removal of blood from the atrium.
  3. Fibrosis. With its development, it is about the compaction of the lungs. As a result, the body undergoes inflammatory changes.
  4. Disturbance of the structure of the interventricular septum. Anomaly provokes the mixing of atrial and ventricular blood. As a result, the organs are supplied with blood containing little oxygen. This provokes the emergence of a compensatory mechanism and an increase in the ventricle.
  5. Valvular stenosis in the lungs. Anomaly provokes problems with the penetration of blood into the artery.
  6. Pneumosclerosis. During its development instead of lung tissue appear connective.
  7. Pulmonary hypertension. It is accompanied by an increase in pressure in the pulmonary artery, which provokes ventricular hyperfunction.
  8. Tetrad Fallot. Pathology is a congenital heart defect, which is accompanied by the release of blood from the right ventricular region.
  9. Bronchial asthma.
  10. Bronchitis.
  11. Pneumonia.

Features of the violation in children

With the growth of the baby increases the load on the heart. With problems with blood circulation there is a risk of increasing the mass of the right ventricle.

With prolonged presence of hypertrophy, secondary damage to the vessels of the lungs is observed. They acquire greater rigidity and lose their elasticity. This provokes a worsening of the symptoms of the disease.

Hypertrophy of the right ventricle of the heart in a child occurs under the influence of the following factors:

  • anomaly of the structure of the cardiac septum (VSD),
  • problems with removing blood from the right ventricle,
  • stenosis in the lungs
  • excessive stress on the heart during intrauterine development.

Signs of illness may not appear immediately, but only after some time. Therefore, for any symptoms of myocardial structure disorder, an ultrasound should be done after birth. In children, this anomaly is much more common.

Clinical picture

Signs of right ventricular hypertrophy resemble the symptoms of other abnormalities. Initially, the disease develops asymptomatically and manifests itself only with a significant increase in weight and size of the ventricle.

The characteristic manifestations of anomalies include the following:

  • prolonged pain in the right chest - suddenly appears and has a piercing character,
  • arrhythmia,
  • dyspnea,
  • swelling of the legs - increases in the evening,
  • dizziness - can provoke a loss of orientation in space and even fainting.

The clinical symptoms of hypertrophic changes are increased heart rate. Also, the violation is accompanied by a sudden drop in blood pressure.

This form of pathology is characterized by pulmonary heart. Its occurrence is due to pulmonary thromboembolism. This anomaly is accompanied by acute right ventricular failure, the sudden appearance of shortness of breath, a drop in pressure, and symptoms of tachycardia. Often this violation leads to death.

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Chronic pulmonary heart has similar symptoms as the acute form of the disease, until the process of decompensation is observed. In severe cases of the disease, chronic pulmonary obstruction appears.

Treatment of HPD

The key task of therapy is to normalize the size of the heart, in particular, its right ventricle. With the development of hypertrophy, the treatment regimen includes the following components:

  • the use of drugs - helps to cope with stenosis, normalize lung function, eliminate heart defects,
  • power correction,
  • normalization of lifestyle.

Important: Treatment should be carried out under strict medical supervision. During the period of therapy, it is imperative to evaluate the function of the heart and determine the frequency of contractions.

Drug treatment

With the development of hypertrophic changes in the right ventricle, the following categories of drugs can be used:

  • diuretic drugs - they should be used systematically,
  • beta blockers,
  • preparations containing potassium and magnesium,
  • calcium channel antagonists,
  • antihypertensives,
  • anticoagulants,
  • cardiac glycosides - this category of drugs is taken in a minimum quantity.

In addition, other drugs may be used. Quite often, the use of drugs to improve lung function and eliminate pulmonary stenosis is required.

Given the causes of the development of the disease, the following drugs can be used:

  • "Eufillin",
  • "Bronholitin",
  • "Nitrosorbit",
  • "Nitroglycerine",
  • "Bromhexine".

In some situations, these funds have to drink all my life. If there are no favorable changes, there is a need for surgery. It consists in using an artificial valve.

Athletes and people leading an active lifestyle should systematically attend a cardiologist. The same applies to patients with excess weight.

Folk recipes

Only in addition to the standard therapy can certain folk remedies be applied. Before using these recipes, be sure to consult your doctor.

High efficiency possess infusions and decoctions of medicinal plants. You can also use some food.

To improve the condition of hypertrophic changes in the right ventricle, you should use these recipes:

  1. Garlic. This tool perfectly supports the normal functioning of the myocardium. Garlic should be chopped and mixed with honey in equal parts. Remove capacity for 1 week in a dark place. The composition should be shaken periodically. Take 1 large spoon three times a day. This should be done half an hour before meals.
  2. Infusion of Hypericum. To make this tool, you need to take 100 g of grass, add 2 liters of water and cook for 10 minutes on low heat. Then another 1 hour to insist. Strain the finished product, add 200 g of honey and take a third cup three times a day. This is done half an hour before meals. The composition is recommended to keep in the refrigerator.
  3. Tincture of lily of the valley. This remedy has soothing properties and strengthens the heart. To prepare it, you need to take 2 cups of fresh flowers of the plant and add 500 ml of alcohol. Leave for 2 weeks to infuse, strain and drink 10 drops 3 times a day. The product must be diluted with water. It is recommended to take it before meals.
  4. Nettle. To get a useful composition you need to mix in equal parts nettle with honey. Leave for 2 weeks to infuse. Then heat on the steam bath and strain. Ready means to put in the fridge. Drink 4-5 times a day.

Possible consequences

If you do not start treating the pathology in time, it will lead to dangerous health consequences. One of the most serious complications is the pulmonary heart. It is characterized by such signs:

  • severe and sharp pain behind the sternum,
  • sudden drop in pressure
  • progressive liver enlargement
  • neck vein swelling,
  • sudden psychomotor agitation,
  • abrupt emergence of abnormal ripple.

If a thromboembolism occurs, a person has symptoms of shock in just a couple of minutes. They are accompanied by severe pulmonary edema.

In such a situation, a large amount of transudate from the capillaries enters the lungs. This leads to severe shortness of breath and tightness in the chest. Then there is choking, blue skin, cough. In approximately 30% of cases, the anomaly is fatal.

The prognosis of the pathology depends on the timeliness of detection and the adequacy of the therapy. If the disease was diagnosed at an early stage of development, it is well treatable. Otherwise, the violation leads to irreversible changes in the heart.

As for military service, it all depends on the presence of associated pathologies. If hypertrophy is accompanied by arterial hypertension, the recruit may be exempted from military service.

Prevention

In order to prevent the appearance of hypertrophic processes in the right ventricle, it is necessary to engage in the prevention of pulmonary pathologies:

  • avoid drafts
  • eliminate smoking
  • do not supercool
  • apply oxygen therapy,
  • do sport,
  • timely treat viral lesions of the respiratory organs.

Hypertrophic damage to the right ventricle often provokes negative health effects. To minimize the risk of dangerous complications, it is necessary to consult a cardiologist in time and strictly adhere to his recommendations.

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