Heart & Cardiology/Left Ventricular Hypertrophy Questions
Hello Dr Ahmed,
How are you?
A few question about left ventricular hypertrophy (LVH) if I can. I saw "LVH" on my Dr's CVD software when she was calculating my risk and was intrigued why it had such a big role in mortality predictions (along with BSL, BP and lipids). (I don't have LVH, BTW).
1. From the diagram attached I was trying to understand why it is only this part of the heart that is prone to the disease. (I'm assuming my arrow points to the left ventricle?) Perhaps this is the part of the heart that has the job of ejecting blood into the rest of the body, the workhorse that bears the brunt of the work?
2. Why is it "hypertrophy" and not "atrophy"? I would have thought atrophy would be the resulting damage ie that part of the heart deteriorates, gets thinner and weaker.
3. If the left ventricle is thickening, surely this is a good sign. A sign the heart is adapting to the workload and getting stronger. Why is it, then, that the consequences of LVH are, in fact, bad? That LVH leads to damage to the heart's electrical signalling, shortness of breath, fainting etc.
As always, my thanks to you. I stand in awe of cardiac surgeons who operate on the heart.
The left side of the heart is the one that pumps to the systemic circulation. Its therefore this side that pumps against high blood pressure in someone with high blood pressure. Its like lifting weights in a gym, if you life heavier weights the muscle gets bigger, in the same way the heart muscle gets bigger nan attempt to compensate, This is a process known as remodeling, Unfortunately over time the process of hypertrophy and remodeling is known to be associated with deleterious consequences that include heart failure. In some cases the heart dilates and thins out in the late stages known as dilated cardiomyopathy. In concentric hypertrophy the heart becomes big and thick and cannot relax normally, this is known as diastolic dysfunction whereby the heart is hard to distend leading to congestion, think of this as like trying to blow up a hot water bottle as opposed to a normal balloon.
Hope that was helpful!