Left ventricular hypertrophy

Diagnosis

Your health care provider does a physical exam and asks questions about your symptoms and family's health history. The care provider checks your blood pressure and listens to your heart with a device called a stethoscope.

Tests

If your health care provider thinks you have left ventricular hypertrophy, imaging tests may be done to look at the heart.

Tests used to diagnose left ventricular hypertrophy may include:

• Lab tests. Blood and urine tests may be done to check for conditions that affect heart health. Tests may be done to check blood sugar, cholesterol levels, and liver and kidney function.
• Electrocardiogram. Also called an ECG or EKG, this quick and painless test measures the electrical activity of the heart. During an ECG, sensors called electrodes are attached to the chest and sometimes to the arms or legs. Wires connect the sensors to a machine, which displays or prints results. An ECG can show how well the heart is beating. Your care provider can look for signal patterns that suggest thickened heart muscle tissue.
• Echocardiogram. An echocardiogram uses sound waves to create pictures of the heart in motion. This test shows blood flow through the heart and heart valves. It can show thickened heart muscle tissue and heart valve problems related to left ventricular hypertrophy.
• Heart MRI. This test, also called a cardiac MRI, uses magnetic fields and radio waves to create detailed images of the heart.

Treatment

Treatment for left ventricular hypertrophy depends on the underlying cause. It may include medications, catheter procedures or surgery. It's important to manage conditions such as high blood pressure and sleep apnea, which can cause blood pressure to be higher.

Medications

Medicines are used to treat symptoms and prevent complications of left ventricular hypertrophy. Blood pressure drugs may help reduce or prevent thickening of the heart muscle. The type of medication prescribed depends on the cause of left ventricular hypertrophy.

Medications that might be used to treat left ventricular hypertrophy or the conditions that cause it include:

• Angiotensin-converting enzyme inhibitors. Also called ACE inhibitors, these medications widen blood vessels to lower blood pressure. They can improve blood flow and decrease the strain on the heart. Side effects include a persistent cough.
• Angiotensin II receptor blockers. Also called ARBs, these medicines have benefits similar to ACE inhibitors but don't cause a persistent cough.
• Beta blockers. These drugs help control the heart rate. They also help the heart move blood with less force.
• Calcium channel blockers. These drugs relax the heart muscle and widen blood vessels. This reduces blood pressure.
• Water pills, also called diuretics. These drugs reduce the amount of fluid in the body, lowering blood pressure.

Surgery or other procedures

Left ventricular hypertrophy that is caused by aortic valve stenosis might require a catheter procedure or surgery to repair or replace the valve.

Surgery or other procedures may be needed to treat underlying conditions.

• Hypertrophic cardiomyopathy. Surgery may be done if the condition causes heart failure symptoms or a blockage that interferes with the heart's pumping action.
• Amyloidosis. If other treatments don't work, a stem cell transplant may be needed. Treatment for amyloidosis is available at specialized clinics.

Together you and your provider can develop a treatment plan that's best for you.

Lifestyle and home remedies

Lifestyle changes can help lower blood pressure and boost heart health. Try these healthy lifestyle changes:

• Eat a nutritious, healthy diet. Choose fruits, vegetables, whole grains, low-fat dairy products and good fats, such as olive oil. Limit foods and beverages higher in added sugars, salt and saturated fat. Choose low-sodium or no-salt-added foods. Don't add salt to your meals.
• Don't smoke or use tobacco. Quitting is the best way to reduce the risk of heart disease and its complications. If you need help quitting, talk to your provider.
• Limit or avoid alcohol. Alcohol can raise blood pressure, especially if consumed in large amounts. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.
• Exercise regularly. Regular physical activity helps to lower blood pressure. With your provider's OK, aim for at least 30 minutes of physical activity most days of the week. Some sports or exercises can temporarily raise blood pressure. Talk to your health care provider about the amount and type of exercise that's best for you.
• Manage weight. If you are overweight or have obesity, losing just a few pounds can help lower blood pressure. Weight loss may help reverse left ventricular hypertrophy. Talk with your care provider to set realistic goals for weight.
• Manage stress. Find ways to help reduce emotional stress. Getting more exercise, practicing mindfulness and connecting with others in support groups are some ways to reduce stress.

Preparing for your appointment

You may be referred to a doctor trained in treating heart diseases. This type of provider is called a cardiologist.

What you can do

• Write down your symptoms, including any that may seem unrelated to the reason why you scheduled the appointment.
• Make a list of all your medications, vitamins and supplements.
• Write down important medical information, including other conditions you may have.
• Write down key personal information, including any recent life changes or stressors in your life.
• Write down questions to ask your health care provider.
• Find out if your family has a history of heart disease.
• Ask a relative or friend to come with you to help you remember what the care provider says.

Questions to ask your doctor

• What's the most likely cause of my symptoms?
• What tests do I need? How do I prepare for them?
• What types of treatments do I need?
• Should I make any lifestyle changes?
• Should I restrict any of my activities?
• I have other health problems. How can I best manage these conditions together?

Don't hesitate to ask any other questions during your appointment.

What to expect from your doctor

Your health care provider is likely to ask you many questions. Being ready to answer them may leave time to go over items you want to spend more time on. You may be asked:

• What are your symptoms?
• When did the symptoms start?
• Have your symptoms gotten worse over time?
• Do you have chest pain or rapid, fluttering or pounding heartbeats?
• Do you have dizziness? Have you ever fainted?
• Have you had trouble breathing?
• Does exercise or lying down make your symptoms worse?
• Have you ever coughed up blood?
• Do you have a history of high blood pressure or rheumatic fever?
• Do you have a family history of heart problems?
• Do you or did you smoke?
• Do you use alcohol or caffeine?