Overview

Left ventricular hypertrophy is thickening of the walls of the lower left heart chamber. The lower left heart chamber is called the left ventricle. The left ventricle is the heart's main pumping chamber.

During left ventricular hypertrophy, the thickened heart wall can become stiff. Blood pressure in the heart increases. The changes make it harder for the heart to effectively pump blood. Eventually, the heart may fail to pump with as much force as needed.

Uncontrolled high blood pressure is the most common cause of left ventricular hypertrophy. Complications include irregular heart rhythms, called arrhythmias, and heart failure.

Treatment of left ventricular hypertrophy depends on the cause. Treatment may include medications or surgery.

Symptoms

Left ventricular hypertrophy usually develops gradually. Some people do not have symptoms, especially during the early stages of the condition.

Left ventricular hypertrophy itself doesn't cause symptoms. But symptoms may occur as the strain on the heart worsens. They may include:

  • Shortness of breath, especially while lying down
  • Swelling of the legs
  • Chest pain, often when exercising
  • Sensation of rapid, fluttering or pounding heartbeats, called palpitations
  • Fainting or a feeling of lightheadedness

When to see a doctor

Seek emergency care if:

  • You feel chest pain that lasts more than a few minutes
  • You have severe difficulty breathing
  • You have severe lightheadedness or lose consciousness
  • You have a sudden, severe headache, difficulty speaking, or weakness on one side of your body

If you have mild shortness of breath or other symptoms, such as palpitations, see your health care provider.

If you have high blood pressure or another condition that increases the risk of left ventricular hypertrophy, your provider is likely to recommend regular health checkups to check your heart.

From Mayo Clinic to your inbox

Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Causes

Anything that puts stress on the heart's lower left chamber can lead to left ventricular hypertrophy. The lower left chamber is called the left ventricle. As the strain on the left ventricle increases, the muscle tissue in the chamber wall thickens. Sometimes, the size of the heart chamber itself also increases.

Left ventricular hypertrophy also may be caused by gene changes that affect the heart muscle's structure.

Things that can cause the heart to work harder and may possibly lead to left ventricular hypertrophy include:

  • High blood pressure. Also called hypertension, this is the most common cause of left ventricular hypertrophy. Long-term high blood pressure strains the left side of the heart, causing it to grow bigger. Treating high blood pressure can help reduce left ventricular hypertrophy symptoms and may even reverse it.
  • Narrowing of the aortic valve. The aortic valve is between the lower left heart chamber and the body's main artery, called the aorta. Narrowing of the valve is called aortic stenosis. When the valve is narrowed, the heart must work harder to pump blood into the aorta.
  • Intensive athletic training. Intense, long-term strength and endurance training causes changes in the heart. The changes help the heart adapt to the extra physical workload. But the changes can make the heart muscle grow larger. Sometimes this is called athlete's heart or athletic heart syndrome. It's unclear whether the increased heart size in athletes can lead to stiffening of the heart muscle and disease.

Certain conditions passed down through families — called genetic conditions — can make the heart thicker. They include:

  • Hypertrophic cardiomyopathy. This condition is caused by changes in genes that cause the heart muscle to thicken. The thickening makes it harder for the heart to pump blood. It can occur even without high blood pressure. People with one parent with hypertrophic cardiomyopathy have a 50% chance of having the genetic mutation for the disease.
  • Amyloidosis. Proteins build up around the organs, including the heart. The protein buildup interferes with how the organs work. When the condition is passed down through families, it is called familial amyloidosis. The inherited disorder also may affect the nerves and kidneys.

Risk factors

Things that increase the risk of left ventricular hypertrophy include:

  • Age. Left ventricular hypertrophy is more common in older people. So is high blood pressure, which can cause heart muscle thickening.
  • Weight. Being overweight increases the risk of high blood pressure and left ventricular hypertrophy.
  • Family history. Changes in genes passed down through families may lead to left ventricular hypertrophy.
  • Diabetes. Having diabetes increases the risk of left ventricular hypertrophy.
  • Female gender. Women with high blood pressure are more likely to get the condition than are men with similar blood pressure measurements.

Complications

Left ventricular hypertrophy changes the structure and function of the heart. The thickened left ventricle becomes weak and stiff. This prevents the lower left heart chamber from filling properly with blood. As a result, blood pressure in the heart increases.

As a result of these changes, complications of left ventricular hypertrophy include:

  • Heart failure
  • Irregular heart rhythms, called arrhythmias
  • Too little oxygen to the heart, called ischemic heart disease
  • Sudden, unexpected loss of heart function, breathing and consciousness, called sudden cardiac arrest

Prevention

The same healthy lifestyle changes recommended to treat heart diseases and high blood pressure also help prevent it. To prevent left ventricular hypertrophy caused by high blood pressure:

  • Don't smoke
  • Eat healthy foods
  • Use less salt
  • Limit or avoid alcohol
  • Exercise regularly
  • Maintain a healthy weight
  • Get 7 to 9 hours of sleep daily
  • Manage stress

Uncontrolled high blood pressure increases the risk of left ventricular hypertrophy. Get your blood pressure checked at least every two years if you're 18 and older. If you have risk factors for heart disease or are over age 40, you may need more-frequent checks. Ask your health care provider what blood pressure reading is best for you. Your provider may recommend checking your blood pressure at home. Home blood pressure monitoring devices are available at local stores and pharmacies.

The Mayo Clinic experience and patient stories

Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care like they've never experienced. See the stories of satisfied Mayo Clinic patients.

Sept. 24, 2022

Living with left ventricular hypertrophy?

Connect with others like you for support and answers to your questions in the Heart & Blood Health support group on Mayo Clinic Connect, a patient community.

Heart & Blood Health Discussions

pop77
Living with high calcium score

42 Replies Sun, May 26, 2024

csage1010 (Sue)
Anyone else out there with extremely high lipoprotein (a)?

98 Replies Fri, May 17, 2024

ashby1947
Does anyone have experience with Palliative Care?

131 Replies Sun, May 19, 2024

See more discussions
  1. Lovic D, et al. Left ventricular hypertrophy in athletes and hypertensive patients. Journal of Clinical Hypertension. 2017; doi:10.1111/jch.12977.
  2. Podrid PJ. Left ventricular hypertrophy and arrhythmia. https://www.uptodate.com/contents/search. Accessed June 22, 2022.
  3. Ommen SR, et al. 2020 AHA/ACC guideline for the diagnosis and treatment of patients with hypertrophic cardiomyopathy: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Journal of the American College of Cardiology. 2020; doi:10.1016/j.jacc.2020.08.045.
  4. Ferri FF. Cardiomyopathy, hypertrophic. In: Ferri's Clinical Advisor 2023. Elsevier; 2023. https://www.clinicalkey.com. Accessed June 22, 2022.
  5. Marion MS. Hypertrophic cardiomyopathy: Clinical manifestations, diagnosis, and evaluation. https://www.uptodate.com/contents/search. Accessed June 22, 2022.
  6. Goldberger AL. Left ventricular hypertrophy: Clinical findings and ECG diagnosis. https://www.uptodate.com/contents/search. Accessed June 22, 2022.
  7. What is left ventricular hypertrophy? American Heart Association. https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/heart-valve-problems-and-causes/what-is-left-ventricular-hypertrophy-lvh. Accessed June 22, 2022.
  8. Lopez-Jimenez F (expert opinion). Mayo Clinic. March 1, 2018.
  9. Libby P, et al., eds. Systemic hypertension: Mechanisms, diagnosis, and treatment. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed June 22, 2022.
  10. AskMayoExpert. Hypertrophic cardiomyopathy (Adult). Mayo Clinic; 2021.
  11. 2020-2025 Dietary Guidelines for Americans. U.S. Department of Health and Human Services and U.S. Department of Agriculture. https://www.dietaryguidelines.gov. Accessed June 22, 2022.
  12. Arnett DK, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019; doi:10.1161/CIR.0000000000000678.
  13. Mehra R. Obstructive sleep apnea and cardiovascular disease in adults. https://www.uptodate.com/contents/search. Accessed June 22, 2022.
  14. Whelton PK, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018; doi:10.1161/HYP.0000000000000065.
  15. Rethinking drinking: How much is too much? National Institute on Alcohol Abuse and Alcoholism. https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/Whats-the-harm/What-Are-The-Risks.aspx. Accessed June 22, 2022.
  16. Ferri FF. Amyloidosis. In: Ferri's Clinical Advisor 2023. Elsevier; 2023. https://www.clinicalkey.com. Accessed June 22, 2022.
  17. Physical Activity Guidelines for Americans. 2nd ed. U.S. Department of Health and Human Services. https://health.gov/our-work/nutrition-physical-activity/physical-activity-guidelines/current-guidelines. Accessed June 22, 2022.
  18. High blood pressure. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/high-blood-pressure. Accessed June 22, 2022.
  19. Phillips SD (expert opinion). Mayo Clinic. Oct. 22, 2020.
  20. Hypertrophic cardiomyopathy. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hypertrophic-cardiomyopathy/symptoms-causes/syc-20350198. Accessed Aug. 3, 2022.
  21. Amyloidosis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/amyloidosis/symptoms-causes/syc-20353178. Accessed Aug. 3, 2022.
  22. Hypertension in adults: Screening. U.S. Preventive Services Task Force. https://uspreventiveservicestaskforce.org/uspstf/draft-update-summary/hypertension-in-adults-screening. Accessed June 21, 2022.
  23. Appel AJ, et al. Overweight, obesity, and weight reduction in hypertension. https://www.uptodate.com/contents/search. Accessed June 21, 2022.
  24. Mankad R (expert opinion). Mayo Clinic. Sept. 6, 2022

Left ventricular hypertrophy