This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

LVH

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Left ventricular hypertrophy (LVH) is sometimes assumed to occur only as a consequence of hypertension. However this is often not the case. LVH is 'an independent risk factor for myocardial infarction and death in men and women with hypertension, and in asymptomatic subjects with normal blood'. The presence of LVH increases the risk of myocardial infarction for a given level of hypertension (1)

Investigations of LVH:

  • echocardiography is more sensitive than ECG in detection of LVH

Signs of LVH include:

  • left ventricular heave, forceful apex beat
  • loud aortic second heart sound
  • signs of underlying cause

Management:

  • seek expert advice
  • patients with LVH should be identified as it increases the risk of developing a myocardial infarction with a level of hypertension that would not normally be indicative for treatment
  • if LVH exists then treatment options include blood control with ACE inhibitors, beta blockers without intrinsic symphathomimetic activity, dihydropyridine calcium channel blockers

Notes:

  • LVH in athletes
    • regular exercise may lead to functional and structural adaptations that improve cardiac function
      • the increase in ventricular wall thickness before reaching the level of hypertrophic cardiomyopathy or a 'gray zone' is considered to be a benign physiological phenomenon, also known as 'athlete's heart syndrome' (2,3)
        • prevalence of myocardial hypertrophy (MH) in athletes differs depending on age, gender, ethnicity, type of sport and the extent and intensity of training
        • relationship between MH and the electrophysiology of the myocardium differs between physiological and pathological variants (4)
        • athletic heart with physiological LVH is a relatively benign condition (5)

Reference:

  • Chambers J. Left ventricular hypertrophy. BMJ 1995;311: 273-4.
  • Hosseini M, Piri M, Agha-Alinejad H, Haj-Sadeghi Sh. The effect of endurance, resistance and concurrent training on the heart structure of female students. Biol. Sport. 2012;29(1):17-21.
  • Sharma S. Athlete's heart - effect of age, sex, ethnicity and sporting discipline. Exp. Physiol. 2003;88(5):665-669
  • Lutfullin IY et al. A 24-hour ambulatory ecg monitoring in assessment of qt interval duration and dispersion in rowers with physiological myocardial hypertrophy. Biol Sport. 2013 Dec;30(4):237-41.
  • Bornstein AB, Rao SS, Marwaha K. Left Ventricular Hypertrophy. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557534/

Related pages

Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page