During a checkup, my doctor said that my examination and tests were normal except for left ventricular hypertrophy on the electrocardiogram. What causes left ventricular hypertrophy. Is it dangerous? Can it be treated?
Left ventricular hypertrophy (LVH) is an enlargement of the left ventricle, the heart chamber that pumps blood through the aorta to all of the body except the lungs. The enlargement may involve either thickening of the wall of the left ventricle or an increase in the size of the chamber itself. The most common causes of LVH are high blood pressure, obesity and disorders of this aortic heart valve. The frequency of LVH rises with age, especially after menopause in women. Other causes of LVH include increased physical activity, excessive alcohol intake and the insulin resistance associated with abdominal obesity and adult onset diabetes.
Although LVH can often be diagnosed by abnormalities on an electrocardiogram (ECG), an ultrasound measurement (echocardiography) is more sensitive for detecting smaller degrees of LVH.
The major danger of LVH is a significant increase in the risk of coronary artery disease and heart attacks. LVH also is associated with greater likelihood of congestive heart failure, heart rhythm disturbances, strokes and premature death from cardiovascular disease.
There is now good evidence that the extent of LVH can be diminished by reducing blood pressure, by lifestyle measures (weight loss, exercise, low-salt diet and decreased alcohol intake) alone or combined with anti-hypertensive drugs. A recent study showed that all of the anti-hypertensive drugs were equally effective in reducing the amount of LVH.
To date, only one report is available on the effects of reducing LVH. Results from the Framingham Heart Study found the lowest cardiovascular mortality in those individuals whose ECGs showed a reduction in LVH over time compared with those whose LVH stayed the same or got worse.
It is unlikely that your LVH is due to an abnormality of your aortic valve because significant aortic valve disease is accompanied by a prominent heart murmur, and your doctor said your heart examination was normal.
Margolis is professor of medicine and biological chemistry at the Johns Hopkins School of Medicine.
Pub Date: 5/07/96
