Left Ventricular Hypertrophy

What is left ventricular hypertrophy?

The left ventricle is the main chamber of your heart. It is responsible for pumping oxygen-rich blood into your aorta (the largest artery in the body). If the heart has to work too hard to pump blood, the muscles in the walls of the left ventricle thicken. This thickening is called hypertrophy. Hypertrophy means growing (trophy) too much (hyper).

Left ventricular hypertrophy (LVH) makes it harder for the heart to pump blood efficiently. It can result in a lack of oxygen to the heart muscle. It can also cause changes to the heart’s conduction system that make it beat irregularly (arrhythmia).

How common is left ventricular hypertrophy?

Left ventricular hypertrophy affects an estimated 15% to 20% of the population — nearly 1 in 5 people. You may have an increased risk of LVH if you have high blood pressure or have obesity, are elderly or Black.

How serious is left ventricular hypertrophy?

Left ventricular hypertrophy usually occurs as a result of other heart problems. Together, they can raise your risk of serious complications. Left untreated, LVH affects your heart’s ability to pump blood efficiently. These changes increase your risk of other cardiac issues, including:

• Arrhythmia.
• Heart attack.
• Heart failure.
• Stroke.

What causes left ventricular hypertrophy?

The most common cause of left ventricular hypertrophy is high blood pressure (hypertension). High blood pressure makes your heart work harder than normal. The extra work it takes to pump blood can cause the muscle in the left ventricle walls to get larger and thicker.

Intense athletic training can sometimes lead to an increase in the size and thickness of the left ventricle walls. But in most cases, athletes’ hearts still function normally and don’t require the same treatment as those with disease-driven LVH.

Other conditions that make your heart work harder and can lead to LVH include:

• Arrhythmia: When you have an irregular heart rhythm, your heart may beat many times faster than normal. This can damage the heart and lead to less blood flow.
• Aortic valve stenosis: This condition causes the aortic valve to narrow, making it more difficult for blood to pass through.
• Diabetes: High blood sugar levels that occur with diabetes can lead to heart damage.
• Hypertrophic cardiomyopathy: When you have this genetic condition, the muscle in your heart thickens.

What are the symptoms of left ventricular hypertrophy?

People with mild LVH may not notice any symptoms. As the condition worsens, you may experience symptoms including:

• Chest pain.
• Dizziness or fainting (syncope).
• Fast or irregular heartbeat.
• Fatigue.
• Shortness of breath.

How is left ventricular hypertrophy diagnosed?

Even if you aren’t having symptoms of LVH, your healthcare provider may find it during a routine heart screening. Tests used to diagnose left ventricular hypertrophy include:

• Echocardiogram (echo test).
• Electrocardiogram (EKG).
• MRI.

How is left ventricular hypertrophy managed or treated?

Treating the underlying cause of left ventricular hypertrophy will help stop or slow disease progression. Depending on the cause, treatment may include:

• Blood pressure medication: Lowering your blood pressure will help prevent left ventricular hypertrophy from worsening. Keeping blood pressure at a healthy level can reduce your risk of heart failure, heart attack or stroke.
• Heart valve surgery: If left ventricular hypertrophy is the result of aortic valve stenosis, you may need aortic valve surgery. The surgery replaces the narrowed valve, allowing blood to flow properly.
• Lifestyle changes: Heart-healthy habits — including eating well and getting regular exercise — can lower your blood pressure and reduce LVH complications.

Can left ventricular hypertrophy be prevented?

If you have a heart condition that could lead to LVH, catching and treating it early can make a big difference. Treatment can help prevent left ventricular hypertrophy from developing. It can also reduce the risk of damage to your heart muscle.

Preventing or managing high blood pressure is the best way to prevent left ventricular hypertrophy. In addition to taking any medications prescribed by your healthcare provider, you should:

• Eat a heart-healthy diet.
• Exercise regularly.
• Maintain a healthy weight.
• Manage stress.
• Stop smoking and/or using tobacco products.

What is the prognosis (outlook) for people with left ventricular hypertrophy?

Left untreated, LVH (and related underlying heart conditions) increases your risk of serious heart disease or even death. Treatment to slow or stop the progression of left ventricular hypertrophy lowers the risk of severe heart damage. An early and accurate diagnosis is the key to improving the outlook for people with left ventricular hypertrophy.

When should I call the doctor?

You should call your healthcare provider if you experience:

• Severe chest pain.
• Shortness of breath.
• Signs of stroke.
• Sudden racing or irregular heartbeat.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

• Should I have testing to look for signs of left ventricular hypertrophy?
• What medications will I need to take to manage my condition?
• Will I need heart surgery?
• What lifestyle changes can I make to improve my heart health?

A note from Cleveland Clinic

Left ventricular hypertrophy typically results from underlying heart conditions or high blood pressure. Taking steps to improve your heart health is the best way to prevent LVH and any related heart damage. It’s never too late to work to improve your health.