Overview

Left ventricular hypertrophy is enlargement and thickening (hypertrophy) of the walls of your heart's main pumping chamber (left ventricle). The thickened heart wall loses elasticity, leading to increased pressure to allow the heart to fill its pumping chamber to send blood to the rest of the body. Eventually, the heart may fail to pump with as much force as needed.

Left ventricular hypertrophy is more common in people who have uncontrolled high blood pressure. But no matter what your blood pressure is, developing left ventricular hypertrophy puts you at higher risk of congestive heart failure and irregular heart rhythms.

If left ventricular hypertrophy is caused by high blood pressure, treating high blood pressure can help ease your symptoms and may reverse left ventricular hypertrophy.

Symptoms

Left ventricular hypertrophy usually develops gradually. You may experience no signs or symptoms, especially during the early stages of the condition.

As left ventricular hypertrophy progresses, you may experience:

  • Shortness of breath
  • Fatigue
  • Chest pain, often after exercising
  • Sensation of rapid, fluttering or pounding heartbeats (palpitations)
  • Dizziness or fainting

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 experience mild shortness of breath or other symptoms, such as palpitations, see your doctor.

If you have high blood pressure or another condition that increases your risk of left ventricular hypertrophy, your doctor is likely to recommend regular appointments to monitor your heart.

Causes

Left ventricular hypertrophy has several causes — one is an increase in the size of heart muscle cells and the other is abnormal tissue around the heart muscle cells.

Your heart muscle cells may get larger in response to some factor that causes the left ventricle to work harder, such as high blood pressure or a heart condition. As the left ventricle's workload increases, the muscle tissue in the chamber wall thickens. Sometimes, the size of the chamber itself also increases.

Left ventricular hypertrophy may also develop due to problems in the structure of the heart muscle cell. These changes can be related to a genetic defect. Abnormal tissue around the heart muscle cells is a result of several rare conditions.

Factors that can cause your heart to work harder include:

  • High blood pressure (hypertension). This is the most common cause of left ventricular hypertrophy. More than one-third of people show evidence of left ventricular hypertrophy at the time of their diagnosis with hypertension.
  • Aortic valve stenosis. This disease is a narrowing of the aortic valve that separates the left ventricle from the large blood vessel leaving your heart (aorta). The narrowing of the aortic valve requires the left ventricle to work harder to pump blood into the aorta.
  • Athletic training. Intense, prolonged endurance and strength training can cause the heart to adapt to handle the extra workload. It's unclear whether this athletic type of left ventricle hypertrophy can lead to stiffening of the heart muscle and disease.

Abnormalities in heart muscle cell structure that result in increased heart wall thickness include:

  • Hypertrophic cardiomyopathy. This genetic disease occurs when the heart muscle becomes abnormally thick, even with completely normal blood pressure, making it harder for the heart to pump blood.
  • Amyloidosis. A condition that causes abnormal protein deposits around the organs, including the heart.

Risk factors

In addition to hypertension and aortic valve stenosis, factors that increase your risk of left ventricular hypertrophy include:

  • Age. Left ventricular hypertrophy is more common in older people.
  • Weight. Being overweight increases your risk of high blood pressure and left ventricular hypertrophy.
  • Family history. Certain genetic conditions are associated with developing left ventricular hypertrophy.
  • Diabetes. The risk of left ventricular hypertrophy is higher in people with diabetes.
  • Race. African Americans may have a higher risk of left ventricular hypertrophy than white people with similar blood pressure measurements.
  • Sex. Women with hypertension are at higher risk of left ventricular hypertrophy than are men with similar blood pressure measurements.

Complications

Left ventricular hypertrophy changes the structure and working of the heart. The enlarged left ventricle can:

  • Weaken
  • Stiffen and lose elasticity, preventing the chamber from filling properly and increasing pressure in the heart
  • Compress the chamber's blood vessels (coronary arteries) and restrict its supply of blood

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

  • Reduced blood supply to the heart
  • Inability of the heart to pump enough blood to your body (heart failure)
  • Abnormal heart rhythm (arrhythmia)
  • Irregular, often rapid heartbeat that increases the risk of stroke
  • Insufficient supply of oxygen to the heart (ischemic heart disease)
  • Stroke
  • Sudden, unexpected loss of heart function, breathing and consciousness (sudden cardiac arrest)

Prevention

The best way to prevent left ventricular hypertrophy caused by high blood pressure is to maintain healthy blood pressure. To better manage your blood pressure:

  • Monitor high blood pressure. Purchase a home blood pressure measuring device and check your blood pressure frequently. Schedule regular checkups with your doctor.
  • Maintain a healthy weight. There's a direct relationship between excess weight and higher blood pressure.
  • Make time for physical activity. Regular physical activity helps to lower blood pressure and keep it at normal levels. Aim for 30 minutes of moderate physical activity most days of the week.
  • Eat a healthy diet. Avoid foods that are high in saturated fat and salt, and eat more fruits and vegetables. Avoid alcoholic beverages or drink them in moderation.
  • Quit smoking. Giving up smoking improves your overall health and prevents heart attacks.