Concentric left ventricular hypertrophy is a cardiac complication that occurs with arterial hypertension. This is a kind of compensatory mechanism for maintaining normal blood circulation at elevated pressure. Pathological changes in the region of the heart muscle do not manifest themselves for a long time, but with a significant thickening of the walls of the myocardium, the main chamber of the heart ceases to function normally. This leads to dangerous complications.
Timely identification and comprehensive treatment of diseases that can provoke myocardial hypertrophy is the main prevention of ischemia.
Feature of violation
Many patients are interested in what it is - concentric hypertrophy of the left ventricle, as it is important to determine the features of the course of the disorder and its manifestations for timely treatment. Intense stress on the heartoccurs with prolonged negative exposure to high pressure.
When such a pathology occurs, the heart muscle functions almost to the point of wear and tear. Thickening and enlargement of the myocardial walls cannot last very long, since as the disease progresses there is a high risk of acute ischemia. In addition, pathology can lead to sudden cardiac death.
In order to treat and reduce the risk of dangerous complications, it is imperative to understand what it is - left ventricular hypertrophy and how life-threatening it is.
Illness in a child
In childhood, concentric hypertrophy of the left ventricle of the heart can be an acquired or congenital form of pathology. The acquired form of the disease is mainly due to carditis, heart disease, pulmonary hypertension. Symptoms of pathology in a child can be very different. A newborn baby becomes restless and noisy, or vice versa - lethargic, refuses to feed.
An older child is able to accurately indicate the nature of the complaints. He is worried about pain in the heart, there is lethargy, pallor, fatigue, shortness of breath. The tactics of the treatment of concentric hypertrophy of the left ventricle is selected by the cardiologist after the examination.
Types of hypertrophy
Concentric left ventricular hypertrophy refers to the thickening of the walls of the heart, due to exposure to variousprovoking factors that can lead to a decrease in the lumen of the chamber. Depending on the degree of thickening of the walls of the heart, moderate and severe pathology is distinguished. Severe concentric hypertrophy of the left ventricle is quite acute. The thickness of the overgrown tissue is more than 25 mm. Moderate concentric hypertrophy of the left ventricular myocardium is characterized by the fact that the width of the tissue growth is approximately 11-21 mm. This form is not life threatening. It is mainly observed in athletes and people engaged in physical labor with significant loads.
Also distinguish hypertrophy with and without obstruction. In the first type, the lesion additionally captures the interventricular septum, as a result of which the region of the left ventricle is shifted closer to the aorta. If the pathology proceeds without obstruction, then it has a more favorable prognosis.
Causes of occurrence
Quite often, concentric left ventricular hypertrophy occurs in the presence of a genetic predisposition. The situation can be aggravated with obesity and high blood pressure. Quite often, the disease develops for reasons such as:
- mitral valve disease;
- arterial stenosis;
- overweight;
- high blood pressure;
- hypertrophic cardiomyopathy;
- stress;
- lung diseases.
The mitral valve regulates blood circulation in the chambers of the heart muscle. If its functioning is disturbed, hypertrophy may develop. Other reasons include being overweight,which leads to the development of numerous disorders in the body, including the occurrence of cardiovascular pathologies.
Often pronounced concentric hypertrophy of the left ventricle develops due to arterial hypertension. Often, other disorders are also associated with this condition, which are clearly visible during an electrocardiogram.
The formation of slight concentric left ventricular myocardial hypertrophy is considered the norm in people who have been professionally involved in sports for a long time. With constant training, the load on the heart is quite strong and constant. As a result, the walls of the left ventricle become somewhat thicker.
Despite the fact that this is considered the norm, it is important not to miss the moment when moderate concentric left ventricular hypertrophy turns into a more complex form. In this regard, athletes are constantly under the supervision of doctors who know exactly in which sport such a condition is permissible, and in which it should not be.
Another reason for the formation of such a pathology is ischemia. In this case, the myocardium experiences a periodic or constant lack of oxygen. Muscle cells without additional supply of energy substrates do not work as efficiently as they should be in the norm. Therefore, the rest of the cells have to function with a much greater load. Gradually thickening of the heart muscle occurs.
Main symptoms
With concentric left ventricular hypertrophysymptoms may vary slightly. Sometimes for a long time the signs of the disorder are completely absent, and the patient is not aware of the presence of pathology until it is detected during the diagnosis. The asymptomatic course of the disease can last for several years in a row.
You can recognize concentric hypertrophy of the left ventricle by the presence of angina pectoris, which often develops against the background of ongoing changes in the heart muscle and its functionality. At the same time, the heart greatly increases in size, since more oxygen is required.
In some cases, atrial fibrillation develops, characterized by atrial fibrillation and oxygen starvation of the myocardium. Often the patient is faced with a condition in which there is literally a sinking heart, as well as a heartbeat stop. The disease in all cases is accompanied by severe shortness of breath, which can increase even with minor exertion. In addition, among the main symptoms of concentric hypertrophy of the walls of the left ventricle, it is necessary to highlight such as:
- headache;
- arrhythmia;
- pressure instability;
- pain in the heart;
- insomnia;
- chest discomfort.
This disease often leads to heart failure and myocardial infarction. If you experience dangerous symptoms, you should immediately consult a doctor. If there is a predisposition to the development of such a pathology, it is required annuallyundergo comprehensive diagnostics.
Diagnostics
To determine the presence of concentric left ventricular myocardial hypertrophy, the doctor initially collects an anamnesis of the course of the disease, evaluates the patient's complaints, and also learns information about the presence of heart pathology in close relatives. To clarify the diagnosis, procedures such as:
- electrocardiogram;
- echocardiography;
- daily monitoring and ECG;
- x-ray;
- doppler test;
- blood test;
- urinalysis.
To determine the degree of the course of the disease, the doctor prescribes coronary angiography. A similar technique is an x-ray study with the introduction of a contrast agent into the cardiac circulation. For better visualization of intracardiac pathology, an MRI of the heart muscle is prescribed.
Echocardiographic criteria for concentric hypertrophy of the left ventricle is the mass of the myocardium, or rather its index. This technique allows you to measure the thickness of the myocardial wall in different segments of the heart muscle. Echocardiographic criteria for concentric left ventricular hypertrophy is the relative thickness of the myocardial wall. The normal structure is characterized by the fact that the OTS is less than 0.45, and the index is within the normal range.
Features of treatment
Treatment of concentric hypertrophy of the left ventricular myocardium must be timely and comprehensive and takesenough time. Therapy is aimed at eliminating the main causes that provoked such a pathology, and involves adjusting the pressure in order to restore normal values with the help of constant intake of antihypertensive drugs. With high vascular resistance, therapy is aimed at eliminating the existing pathology with the help of medications.
Treatment is to slow the development of the disorder. This can be achieved by organizing a he althy lifestyle, which implies the normalization of nutrition, adherence to the daily routine. Consumed foods must be rich in polyunsaturated fats, as the latter help reduce the risk of atherosclerosis. The food should contain vitamins and minerals necessary for the body.
In addition, you need to devote enough time to sleep and rest, moderate physical activity. If there is obesity, then you should definitely reduce weight, since this deviation is one of the reasons for the development of the disease. From physical activity, it is best to give preference to aerobics or swimming. In any case, you can play sports after consulting a doctor. Giving up bad habits has a positive effect on the whole body.
Drug therapy is mandatory for treatment. A person must take medicines throughout life - this is the only way to achieve normalization of well-being. Often, cardiologists prescribe antiarrhythmic drugs and beta-blockers.
If all these measures failbring the desired result, then doctors may recommend surgery. Surgery involves the removal of a hypertrophied area of the heart muscle. Such an operation is very complicated, therefore it is used in the most exceptional cases.
Drug therapy
The basis of treatment is the elimination of the provoking factor that led to the development of hypertrophy. Therapeutic measures necessarily include the use of medications that help normalize blood pressure, eliminate endocrine and metabolic disorders.
In order to lower the heart rate and eliminate oxygen starvation of cells, beta-blockers are prescribed. They help prevent further progression of angina pectoris and provide a reduction in the frequency of painful symptoms. Angiotensin-converting enzyme inhibitors provide protection to affected cells and help prevent secondary damage.
Calcium antagonists are prescribed to reduce the amount of calcium in the cells of the heart muscle. They prevent the formation of various intracellular structures that can provoke the development of hypertrophy. Taking into account the existing signs of such a pathological condition, drugs are prescribed:
- antiarrhythmic;
- cardiac glycosides;
- diuretic;
- antioxidants.
It is worth noting that slight concentric left ventricular hypertrophy is not at all life-threatening and does not requirespecific treatment, but requires monitoring of the patient.
Folk remedies
Folk remedies can be used as an additional therapy to the main treatment. They can be used only after the diagnosis and with the permission of the doctor. Alternative treatment implies the use of medicinal herbs that help get rid of the cause that provoked the disease, its symptoms and are aimed at normalizing well-being.
To prepare a decoction, you will need a mixture of wild rosemary, motherwort, cudweed and kidney tea. All components must be mixed in equal proportions, then take 2 tbsp. l. mixture and pour 300 ml of boiling water. Boil over low heat, cool, strain and take 3 times a day.
A strong infusion of St. John's wort will help strengthen the heart muscle. Before its consumption, you need to add a little honey. Strawberry jam with milk, dried fruits, dried apricots, cranberries with sugar, raisins have a good effect.
Surgery
If drug therapy has not brought the desired result, then surgical techniques may be prescribed for treatment. Interventions shown include:
- mitral valve replacement;
- Operation Morrow;
- commissurotomy;
- aortic valve replacement or transplant;
- stenting of coronary vessels.
Stenting is prescribed in case of myocardial ischemia. An incision is made for aortic stenosis.soldering on the valves. This technique allows you to somewhat reduce the resistance that the ventricular myocardium encounters when blood flows into the aorta. If the therapy does not bring the expected result, then a cardiovertet-defibrillator or a pacemaker is sewn in. These devices are designed to restore the correct rhythm of the heart.
Possible Complications
Moderate hypertrophy is usually harmless. This is a kind of compensatory reaction of the body, designed to normalize the blood supply to tissues and organs. For a long time, a person may not notice the presence of hypertrophy, since it does not manifest itself in any way. As the pathology progresses, the following may develop:
- ischemia, myocardial infarction;
- chronic cerebrovascular accident;
- severe arrhythmia;
- stroke;
- sudden cardiac arrest.
Angina pectoris occurs due to an increase in the size of the myocardium of the heart, and in general this occurs quite unevenly. The coronary arteries are compressed. Angina pectoris is characterized by the presence of chest pains of a pressing or compressive nature. In addition, the disease occurs against the background of high blood pressure and a significant increase in heart rate.
Another dangerous complication is thrombosis. Due to insufficient pumping of blood, blood clots form on the walls of the heart chamber and valves. They arise as a result of damage to the walls and the subsequent settling of red blood cells on them. Such a complication is very dangerous because the thrombus can break off from its place of attachment andplug the vessel.
If hypertrophy proceeds for a long time, then it can eventually become chronic. In this case, edema is formed throughout the body. Patients cannot move normally due to severe shortness of breath, they do not tolerate any load. In later stages, the person is unable to even leave the house.
Forecast
The prognosis of the course of the disease is determined by the root cause of such a violation. In the initial stages of hypertrophy, which is corrected with antihypertensive drugs, the prognosis is quite good. The chronic form develops very slowly, and a person with such a disease can live for several decades. At the same time, his quality of life does not suffer.
In older people with myocardial ischemia, as well as previous heart attacks, the development of the chronic stage is difficult to predict. It can develop both slowly and rapidly, which leads to disability and loss of a person's ability to work.
