Dear Doctor:
I am 48 years old and my physician says I may have LVH. More tests will be taken to identify the problem. There is a slight feeling of heaviness on the left side of my upper rib cage and my blood pressure readings are usually between 135/88 and 138/90. What is LVH? While I am being treated for possible LVH is it possible for me to keep up an exercise routine?
Answer:
Left ventricular hypertrophy (LVH) is an enlargement of the left pumping chamber of the heart and may be due to several different things. The most common cause is high blood pressure. Other causes are due to exercise (athletic hypertrophy) and congenital (hypertrophic cardiomyopathy or HOCM).
The diagnosis of LVH is usually made by echocardiogram. The walls of the ventricle can be measured and a thickness of greater than 1.5 cm is considered enlarged. Athletic hypertrophy is usually less than this thickness and will return to normal size with cessation of the activity. HOCM may be diagnosed in the absence of other causes of LVH and with the presence of a family history.
The treatment of LVH depends on the cause. Hypertensive LVH is treated by controlling the blood pressure. Some antihypertensive drugs may cause LVH to regress but this is controversial. Athletic hypertrophy does not require treatment. HOCM is a rare condition that should be followed by a cardiologist with expertise in this area. It may require medical or surgical management.
Long term prognosis of LVH is good. There is an increased propensity to heart failure (see previous questions on heart failure) so a correct diagnosis and proper treatment is essential to decrease this risk.
I would follow your doctor's instructions in regard to exercise. If athletic hypertrophy is suspected then he may ask you to stop exercising for a time. If the LVH is due to high blood pressure then it may not be necessary to stop exercise.
Reviewed: 4/03