Diagnosis

Your doctor will start with a health history, family history and thorough physical examination including checking your blood pressure and heart function.

Your doctor might then recommend screening tests:

  • Electrocardiogram (ECG or EKG). Electrical signals are recorded as they travel through your heart. Your doctor can look for patterns that indicate abnormal heart function and increased left ventricle muscle tissue.
  • Echocardiogram. Sound waves produce live-action images of your heart. Echocardiogram can reveal thickened muscle tissue in the left ventricle, blood flow through the heart with each beat, and heart abnormalities related to left ventricular hypertrophy, such as aortic valve stenosis.
  • MRI. Images of your heart can be used to diagnose left ventricular hypertrophy.

Treatment

Treatment for left ventricular hypertrophy depends on the underlying cause, and may involve medication or surgery.

Treating high blood pressure

Your doctor is likely to recommend lifestyle changes, including:

  • Regular exercise
  • Low-sodium, low-fat diet
  • Smoking cessation

Blood pressure medication might also help prevent further enlargement of the left ventricle and even shrink your hypertrophic muscles. Your doctor might recommend:

  • Angiotensin-converting enzyme (ACE) inhibitors. These medications widen blood vessels to lower blood pressure, improve blood flow and decrease the heart's workload. Examples include Captopril, Enalapril and Lisinopril.  Side effects might include an irritating dry cough.
  • Angiotensin II receptor blockers (ARBs). Medications such as losartan (Cozaar) have benefits similar to ACE inhibitors but don't cause a persistent cough.
  • Beta blockers. Medications such as atenolol (Tenormin) can lower your heart rate, reduce blood pressure and prevent some of the harmful effects of stress hormones. Beta blockers aren't usually given as an initial treatment for hypertension. Your doctor might recommend adding a beta blocker if another type of medication isn't effective alone.
  • Calcium channel blockers. These medications prevent calcium from entering cells of the heart and blood vessel walls, resulting in lower blood pressure. Examples include amlodipine (Norvasc) and diltiazem (Cardizem).
  • Diuretics. Medications known as thiazide-type diuretics can facilitate blood flow, lowering hypertension. Examples include chlorthalidone and hydrochlorothiazide.

Treating sleep apnea

If you've already been diagnosed with sleep apnea, treating this sleep disorder can lower your blood pressure and help reverse left ventricular hypertrophy.

If you haven't been diagnosed with sleep apnea, but your partner tells you that you snore or that you stop breathing momentarily while you sleep, talk with your doctor about getting tested for sleep apnea.

Sleep apnea treatment involves using a machine that provides continuous positive airway pressure (CPAP) while you sleep. CPAP keeps your airways open, allowing you to get the oxygen you need to keep your blood pressure at a normal level.

Aortic valve repair or replacement

Left ventricular hypertrophy that is caused by aortic valve stenosis might require surgery to repair the narrow valve or to replace it with an artificial or tissue valve.

Lifestyle and home remedies

Lifestyle changes can help lower your blood pressure and improve left ventricular hypertrophy signs. Consider:

  • Weight loss. Left ventricular hypertrophy is often found in obese people regardless of blood pressure. Losing weight has been shown to reverse left ventricular hypertrophy.
  • Limiting salt in your diet. Too much salt can increase your blood pressure. Choose low sodium or no-salt-added foods, and don't add salt to your meals.
  • Drinking alcohol in moderation, if at all. Alcohol can also raise your blood pressure, especially if consumed in large amounts.
  • Regular exercise. Aim for at least 30 minutes of physical activity, such as walking, most days of the week. Ask your doctor if you need to restrict certain physical activities, such as weightlifting, which may temporarily raise your blood pressure.

Preparing for your appointment

You may be referred to a doctor who specializes in disorders of the heart (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 your key medical information, including other conditions.
  • Write down key personal information, including any recent changes or stressors in your life.
  • Write down questions to ask your doctor.
  • Find out if your family has a history of heart disease.
  • Ask a relative or friend to accompany you, to help you remember what the doctor says.

Questions to ask your doctor

  • What's the most likely cause of my symptoms?
  • What tests do I need? Is there any special preparation for them?
  • What kinds 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?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may leave time to go over points you want to spend more time on. You may be asked:

  • What are your symptoms, and when did they begin?
  • 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 difficulty 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?
June 06, 2015
References
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  3. Chatterjee S, et al. Meta-analysis of left ventricular hypertrophy and sustained arrhythmias. American Journal of Cardiology. 2014;114:1049.
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  5. Kaplan NM. Clinical implications and treatment of left ventricular hypertrophy in hypertension. http://www.uptodate.com/home. Accessed April 6, 2015.
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  7. Maron MS et al. Clinical manifestations, diagnosis, and evaluation of hypertrophic cardiomyopathy. http://www.uptodate.com/home. Accessed April 6, 2015.
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  9. Mann DL, et al. Systemic hypertension: Management. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2014.
  10. AskMayoExpert. What tests are needed to confirm the diagnosis of hypertrophic cardiomyopathy (HCM) and what is the role of genetic testing? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
  11. Yilmaz A, et al. Diagnostic approach and differential diagnosis in patients with hypertrophied left ventricles. Heart. 2014;100:662.
  12. James PA, et al. 2014 evidence-based guidelines for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Journal of the American Medical Association. 2014;311:507.
  13. Mehra R. Obstructive sleep apnea and cardiovascular disease. http://www.uptodate.com/home. Accessed April 6, 2015.
  14. Gaasch WH. Course and management of chronic aortic regurgitation in adults. http://www.uptodate.com/home. Accessed April 6, 2015.
  15. Cuspidi C, et al. Left-ventricular hypertrophy and obesity: A systematic review and meta-analysis of echocardiographic studies. Journal of Hypertension. 2014;32:16.
  16. How can high blood pressure be prevented? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/hbp/prevention. Accessed April 6, 2015.

Left ventricular hypertrophy