Doctors believe that if myocardial hypertrophy is asymptomatic, then everything can end in sudden cardiac arrest. It is scary when this happens to young and outwardly he althy people who go in for sports. What happens during this illness, what consequences to expect and whether this pathology is treated - remains to be found in this article.
Description of pathology
It is called an autosomal dominant disease, which is transmitted mainly through heredity and gene mutation, affects the heart. This disease is characterized by an increase in the thickness of the walls of the ventricles. Most often, the pathology is asymmetric, the left ventricle of the heart is more affected. This results in:
- formation of fibrosis sites;
- lesion of small coronary vessels;
- chaotic arrangement of muscle fibers;
- blood flow obstruction - displacement of the mitral valve, which preventsejection of blood from the atrium.
Ventricular myocardial hypertrophy is a rather serious disease.
When there is a large load on the myocardium, which is caused by various diseases, bad habits, sports, the body will begin to defend itself. The heart will need to cope with the increased volume of work without increasing the load per unit of mass. In this case, compensation will occur:
- increase in myocardial muscle mass;
- increased protein production;
- wall thickening;
- hyperplasia - the number of cells increases.
Pathological myocardial hypertrophy
With prolonged work of the myocardium under load, which is constantly increasing, a pathological form of hypertrophic cardiomyopathy occurs. The hypertrophied heart must adapt to new conditions. The myocardium thickens rapidly. In this case happens:
- circulatory failure;
- the influence of nerve tissues on metabolic processes is changing;
- growth of nerves and capillaries lags behind;
- myocardial structures wear out;
- repolarization disorder;
- appears systolic, diastolic dysfunction.
Diagnosis of disease in athletes
The formation of myocardial hypertrophy in athletes is almost imperceptible. As a result of increased physical exertion, the heart begins to pump more and more blood, and the muscles begin to grow in size. Hypertrophy is very dangerous, because in the absence of symptoms and complaintsthere is a heart attack, stroke, sudden cardiac arrest. In order to avoid any complications, you should not abruptly stop playing sports.
Hypertrophy in athletes has three types:
- Concentric hypertrophy - the myocardium increases, the ventricular cavity remains unchanged. Occurs in static and game sports.
- Eccentric hypertrophy is proportional muscle change. Typical for dynamic sports (long distance running, skiing, swimming).
- Mixed hypertrophy - sports activities where immobility and dynamics are used at the same time (biking, rowing, skating).
When this pathology is detected in a child
Myocardial hypertrophy can also occur from birth. It is difficult to diagnose this disease at this age. In most cases, hypertrophic changes in the myocardium are observed in adolescence, during the active growth of cardiomyocyte cells. The anterior and posterior walls thicken up to 18 years, then they stop. The manifestation of ventricular hypertrophy in children is not considered a separate disease, it is rather a sign of other pathologies. Children with this condition usually have:
- myocardial dystrophy;
- angina;
- heart disease;
- hypertension.
Causes of cardiomyopathy
It is necessary to separate the primary and secondary causes of hypertrophy. Primary Causes:
- stress;
- viral infections;
- drinking alcohol;
- heredity;
- overweight;
- excessive exercise;
- toxic poisoning;
- drug use;
- pathological changes during pregnancy;
- microelement deficiency in the body;
- malnutrition;
- autoimmune diseases;
- smoking.
Secondary causes of myocardial hypertrophy include:
- Defects of the heart.
- IHD.
- Neuromuscular diseases.
- Mitral valve insufficiency.
- Aortic stenosis.
- Hypertension.
- Electrolyte imbalance.
- Pulmonary diseases.
- Parasitic processes.
- Disorders of metabolic processes.
- Lack of oxygen in the blood.
- Ventricular septal injury.
- Endocrine disorders.
Let's take a closer look at the signs of left ventricular myocardial hypertrophy.
Hypertrophy of the left ventricle of the heart
Often the pathology affects the walls of the left ventricle. The main reason is increased pressure, which makes the myocardium work at a faster pace. As a result of such overloads, the wall of the left ventricle begins to increase in size. In this case happens:
- loss of myocardial muscle elasticity;
- violation of the normal functioning of the heart;
- slowing blood circulation;
- appearsdanger of sudden stress on the heart.
With myocardial hypertrophy of the left ventricle of the heart, the need of the heart for oxygen and nutrients increases. You can detect changes in left ventricular hypertrophy using instrumental examination. There is a syndrome of small ejection - fainting, dizziness. Signs that accompany hypertrophy:
- pain in the heart;
- pressure drops;
- arrhythmia;
- angina;
- weakness;
- not feeling well;
- headaches;
- shortness of breath at rest;
- strong heartbeat with little exertion;
- fatigue.
Right atrial hypertrophy
Thickening of the walls of the right ventricle is not a disease, it is an anomaly that occurs when there is congestion in this area. This happens as a result of the receipt of a large volume of venous blood from large vessels. These reasons may be:
- stenosis;
- birth defects;
- obesity;
- Atrial septal defects, in which blood simultaneously enters the right and left ventricles.
With right ventricular hypertrophy, these symptoms appear:
- dizziness;
- chest pain;
- hemoptysis;
- fainting;
- shortness of breath without exertion;
- bloating;
- signs of heart failure - enlarged liver, swollen legs;
- arrhythmia;
- night cough;
- malfunction of internal organs;
- heaviness in the hypochondrium;
- cyanosis of the skin;
- enlarged veins in the abdomen.
Ventricular septal hypertrophy
One of the signs of the development of the disease is hypertrophy of the interventricular septum. The main reason for this pathology is gene mutation. Such hypertrophy provokes:
- atrial fibrillation;
- mitral valve pathology;
- impaired blood outflow;
- ventricular fibrillation;
- ventricular tachycardia;
- heart failure;
- impaired blood outflow;
- cardiac arrest.
Symptoms of cardiac hypertrophy
The danger of myocardial hypertrophy is that it often goes away without any symptoms. And the disease is usually diagnosed by chance at a physical examination. During the development of the disease, you can observe the following signs:
- shortness of breath at rest;
- fainting;
- chest pain;
- fatigue;
- heart rhythm disturbances;
- shortness of breath;
- drowsy;
- edema;
- weakness;
- dizziness.
Signs of myocardial hypertrophy are important to be able to recognize in a timely manner.
Classification of hypertrophy
Specialists for convenience in work distinguish the following types of myocardial hypertrophy:
- symmetrical – all walls of the left ventricle are affected;
- asymmetric - only one wall is affected;
- apical - the muscles of the heart increase from above;
- obstructive - for allsquare, at the top of the partition;
- non-obstructive - mild symptoms, found incidentally.
Diagnosis of hypertrophic cardiomyopathy
In the early stages, with a slight development of hypertrophy, it is very difficult to identify the disease. The diagnostic process begins with a patient interview and usually finds out the following details:
- past illnesses;
- presence of pathologies in relatives;
- radiation forcing facts;
- death of a relative at a young age;
- external signs during visual inspection;
- indicators of blood and urine tests;
- blood pressure readings.
There is such a new direction as the genetic diagnosis of myocardial hypertrophy. It will help to identify the parameters of HCM, hardware and radiological methods:
- Ultrasound can assess myocardial thickening and impaired blood flow;
- ECG will determine indirect signs - hypertrophy of departments, rhythm disturbance;
- MRI will give a three-dimensional image of the heart and determine the level of thickness of the myocardium;
- ventriculography determines contractile functions.
Treatment of myocardial hypertrophy
The main goal of treatment is to restore the previous size of the myocardium. Procedures that are aimed at this are carried out in a complex. More likely to cure hypertrophy if early diagnosis has been made. An important part of the myocardial treatment system is lifestyle. Here are the rules to followdoctors:
- stop smoking;
- diet;
- reduce weight;
- restrict s alt intake;
- eliminate drugs;
- quit alcohol.
Treatment of left ventricular myocardial hypertrophy with medication involves taking medications that:
- correct irregular heart rhythm (antiarrhythmics);
- reduce blood pressure - angiotensin receptor antagonists, ACE inhibitors;
- drugs with negative ionotropic effects relax the heart - calcium antagonists from the verapamil group, beta-blockers;
- increase muscle strength - ionotropics;
- remove fluid - diuretics;
- with the threat of infective endocarditis - antibiotic prophylaxis.
It is mandatory for the attending physician to select drugs. Self-medication is unacceptable and fraught with serious consequences.
What to do in case of this pathology? An effective method of treatment that will allow you to change the contractions of the ventricles and the course of excitation is dual-chamber pacing. In more complex cases, with asymmetric IVS hypertrophy, latent obstruction, no effect of the drug, the following will help save the patient's life:
- pacemaker implantation;
- excision of the lobe of the interventricular septum;
- installing a defibrillator;
- transortal septal myectomy;
- transcatheter septal alcohol ablation.
Here everything will depend on the degree of development of the pathology and conditionthe patient himself. We reviewed the symptoms and treatment of left ventricular hypertrophy of the heart.
