诊断

您的医生将首先评估您的健康史、家族史,并进行全面体格检查(包括检查您的血压和心脏功能)。

您的医生可能会建议进行以下筛选检查:

  • 心电图(ECG 或 EKG)。电信号通过心脏时会被记录下来。您的医生可以寻找表明心脏功能异常和左心室肌肉组织增加的规律。
  • 超声心动图。声波产生您心脏的实时动态图像。超声心动图可以显示左心室肌肉组织增厚,心脏每次跳动的血流量,以及与左心室肥大有关的心脏异常,如主动脉瓣狭窄等。
  • 磁共振成像(MRI)。您的心脏影像可用于诊断左心室肥大。

治疗

左心室肥大的治疗取决于潜在病因且可能涉及用药或手术。

Medications

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

  • 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 (Vasotec) and lisinopril (Prinivil, Zestril, Zestoretic). Side effects might include an irritating dry cough in a small percentage of people.
  • Angiotensin II receptor blockers (ARBs). Medications such as losartan (Cozaar) have benefits similar to ACE inhibitors but don't cause a persistent cough.
  • Calcium channel blockers. These medications prevent calcium from entering cells of the heart and blood vessel walls. This relaxes the muscle in the vessel walls, which lets the blood vessels open wider and reduces blood pressure. Examples include amlodipine (Norvasc) and diltiazem (Cardizem, Tiazac).
  • Diuretics. Medications known as thiazide-type diuretics reduce the amount of fluid in your blood vessels, lowering blood pressure. Examples include chlorthalidone and hydrochlorothiazide (Microzide).
  • 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.

主动脉瓣狭窄的治疗

由主动脉瓣狭窄引起的左心室肥大可能需要做手术修复狭窄的瓣膜,或者用人工或组织瓣膜进行替换。

生活方式与家庭疗法

如果左心室肥大是由高血压引起的,改变生活方式可以帮助降低血压,改善心脏健康和左心室肥大症状。可以考虑:

  • 减轻体重。无论血压高低,肥胖人群常伴有左心室肥大。减轻体重已被证明可以逆转左心室肥大。保持健康的体重,或者如果您超重或肥胖,减轻体重也有助于控制血压。
  • 有益于心脏健康的饮食。食用水果、蔬菜、全谷物、低脂乳制品、家禽和鱼类等有益于心脏健康的饮食。
  • 在饮食中限制盐的摄入量。过量的盐可能增加您的血压。选择低钠或无盐添加的食物,不要在饭菜中加盐。
  • 如饮酒,请适量。酒精也会使您的血压升高,尤其是在大量饮酒的情况下。
  • 定期身体活动。目标是每周进行 150 分钟的适度体力活动。例如,在一周的大部分时间尝试快走大约 30 分钟。即使是少量的活动也将提供显著的获益。询问您的医生您是否需要限制某些体力活动,因为如抬重物的活动可能会使您的血压暂时升高。
  • 管理压力。找到管理压力的方法,比如松弛技术。

准备您的预约

You may be referred to a doctor trained in treating heart disease (cardiologist).

您可以做些什么

  • 写下您的症状,包括看似与约诊原因无关的任意症状。
  • 列出您使用的所有药物、维生素和补充剂。
  • 写下您的关键医疗信息,包括其他状况。
  • 写下关键个人信息,包括近期生活中的任何变化或压力。
  • 写下需要向医生咨询的问题
  • 查明您的家人是否有心脏病史。
  • 请一名亲属或朋友陪同您就诊,帮助您记住医生提供的信息。

要向医生咨询的问题

  • 导致我症状最可能的原因是什么?
  • 我需要做哪些检查?是否需要为这些检查做特殊准备?
  • 我需要什么样的治疗?
  • 我是否应当改变生活方式?
  • 我是否应当严格限制我的活动?
  • 我还有其他健康问题。我怎样才能同时管理好这些疾病?

除了您准备咨询医生的问题外,就诊期间还可以随时提出其他问题。

医生可能会做什么

医生可能会询问您一些问题。请做好回答这些问题的准备,这样有利于更好地安排时间,去详细了解您所关注的任何方面。医生可能会问:

  • 您有哪些症状以及这些症状的开始时间?
  • 您的症状是否随时间的推移而加重?
  • 您是否出现胸部疼痛或感觉心跳加速、加剧或加重?
  • 您是否出现头晕?您晕倒过吗?
  • 您是否曾出现过呼吸困难?
  • 运动或躺下是否会加重症状?
  • 您是否曾出现过咳血?
  • 您是否有高血压或风湿热病史?
  • 您是否有心脏问题家族史?
  • 您现在吸烟或有吸烟史吗?您是否饮酒或喝咖啡?
Jan. 13, 2022
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