Concentric hypertrophy of the left ventricle is a cardiac complication that occurs with arterial hypertension. This is a kind of compensatory mechanism for maintaining normal blood circulation with high blood pressure. Pathological changes in the heart muscle for a long time do not manifest themselves at all, 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.
Violation feature
Many patients are interested in what it is - concentric hypertrophy of the left ventricle, since it is important to determine the peculiarity of the course of the disorder and its manifestation for timely treatment. An intense load on the heart occurs with prolonged negative exposure to high blood pressure.
With the occurrence of such a pathology, the heart muscle functions practically for wear. Thickening and enlargement of the walls of the myocardium 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 conduct treatment and reduce the risk of dangerous complications, you must understand what it is - concentric hypertrophy of the left ventricle, and how dangerous it is to life.
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 defects, 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 heart pain, lethargy, pallor, fatigue, shortness of breath. The tactician for the treatment of concentric hypertrophy of the left ventricle is selected by the cardiologist after the examination.
Types of Hypertrophy
Concentric hypertrophy of the left ventricle implies a thickening of the walls of the heart due to various provoking 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, a moderate and severe pathology is distinguished. Severe concentric hypertrophy of the left ventricle is quite acute. Moreover, the thickness of the overgrown tissue is more than 25 mm. Moderate concentric left ventricular myocardial hypertrophy is characterized in that the tissue proliferation width is approximately 11-21 mm. This form is not dangerous for life. It is mainly observed in athletes and people engaged in physical labor with significant loads.
Hypertrophy with obstruction and without it is also distinguished. In the first type, the lesion additionally captures the interventricular septum, as a result of which the region of the left ventricle moves closer to the aorta. If the pathology proceeds without obstruction, then it has a more favorable prognosis.
Causes of occurrence
Quite often, concentric hypertrophy of the left ventricle occurs in the presence of a genetic predisposition. The situation may worsen with obesity and high blood pressure. Quite often, a disease develops for reasons such as:
- damage to the mitral valve;
- arterial stenosis;
- excess weight;
- high pressure;
- hypertrophic cardiomyopathy;
- stress;
- pulmonary diseases.
The mitral valve regulates blood circulation in the chambers of the heart muscle. If its functioning is disturbed, hypertrophy may develop. Among other reasons, it is necessary to highlight excess weight, which leads to the development of numerous disorders in the body, including the occurrence of cardiovascular pathologies.
Often expressed concentric hypertrophy of the left ventricle develops due to arterial hypertension. Often other disorders also join this condition, which are clearly visible when conducting an electrocardiogram.
The formation of minor 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 hypertrophy of the left ventricle passes into a more complex form. In this regard, athletes are constantly under the supervision of doctors who know for sure in which sport this 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 the additional supply of energy substrates do not work as efficiently as they should be normal. Therefore, the remaining cells have to function with a much greater load. Gradually, a thickening of the heart muscle occurs.
Main symptoms
With left ventricular hypertrophy of a concentric type, the symptoms may vary slightly. Sometimes for a long time the signs of the violation 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 several years in a row.
Recognizing concentric hypertrophy of the left ventricle is possible by the presence of angina pectoris, which often develops against the background of ongoing changes in the heart muscle and its functionality. The heart thus greatly increases in size, since a greater supply of oxygen is required.
In some cases, atrial fibrillation develops, characterized by atrial fibrillation and myocardial oxygen starvation. Often, the patient is faced with a condition in which there is literally a sinking heart, as well as a cardiac arrest. The disease in all cases is accompanied by severe shortness of breath, which can worsen even with minor exertion. In addition, among the main symptoms of concentric hypertrophy of the walls of the left ventricle, it is necessary to distinguish such as:
- headache;
- arrhythmia;
- pressure instability;
- heartache;
- insomnia;
- discomfort in the chest area.
Such a disease often leads to heart failure and myocardial infarction. If dangerous symptoms occur, you should immediately consult a doctor. If there is a predisposition to the development of such a pathology, a comprehensive diagnosis is required annually.
Diagnostics
To determine the presence of concentric type left ventricular myocardial hypertrophy, the doctor initially collects a history of the course of the disease, evaluates the patient's complaints, and also finds out information about the presence of heart pathology in close relatives. To clarify the diagnosis, such procedures are prescribed as:
- electrocardiogram;
- echocardiography;
- daily monitoring and ECG;
- X-ray
- Doppler test;
- blood test;
- Analysis of urine.
To determine the extent of the disease, the doctor prescribes coronary angiography. A similar technique is an X-ray study with the introduction of a contrast medium into the cardiac bloodstream. For better visualization of intracardiac pathology, MRI of the heart muscle is prescribed.
The echocardiographic criteria for concentric hypertrophy of the left ventricle is the mass of the myocardium, or rather its index. A similar technique allows you to measure the thickness of the myocardial wall on different segments of the heart muscle. Echocardiographic criteria for concentric hypertrophy of the left ventricle is the relative thickness of the myocardial wall. The normal structure is characterized by the fact that the OTC is less than 0.45, and the index is within normal limits.
Treatment features
Treatment of concentric left ventricular myocardial hypertrophy must be timely and comprehensive and takes a lot of time. Therapy is aimed at eliminating the main causes that provoked such a pathology, and involves adjusting the pressure to restore normal values with the constant use 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 healthy lifestyle, which implies the normalization of nutrition, adherence to the daily regimen. Consumed foods must be rich in polyunsaturated fats, since 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 exercise. If there is obesity, then you should definitely reduce weight, since this deviation is one of the causes of the development of the disease. Of the physical activities, it is best to give preference to aerobics or swimming. In any case, you can engage in sports after consulting a doctor. Refusal of existing bad habits has a positive effect on the whole body.
For treatment, medication is necessarily used. A person should take medicine throughout his life - the only way to achieve normalization of health. Cardiologists often prescribe antiarrhythmic drugs and beta-blockers.
If all these measures do not bring the required result, then doctors can recommend surgery. Surgical intervention involves the removal of a hypertrophied region 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 reduce heart rate and eliminate oxygen starvation of cells, beta-blockers are prescribed. They help prevent even greater 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 their secondary damage.
To reduce the amount of calcium in the cells of the heart muscle, calcium antagonists are prescribed. They prevent the formation of various intracellular structures that can provoke the development of hypertrophy. Given the available signs of such a pathological condition, the following drugs are prescribed:
- antiarrhythmic;
- cardiac glycosides;
- diuretics;
- antioxidants.
It is worth noting that minor concentric hypertrophy of the left ventricle is completely life-threatening and does not require special treatment, but monitoring the patient is required.
Folk remedies
Folk remedies can be used as adjunctive therapy to the main treatment. You can use them only after a diagnosis and with the permission of a doctor. Alternative treatment implies the use of medicinal herbs, which help to get rid of the cause of the disease, its symptoms and are aimed at normalizing well-being.
To prepare the broth, you will need a mixture of rosemary, motherwort, dried cinnamon 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 consuming it, you need to add a little honey. Strawberry jam with milk, dried fruits, dried apricots, cranberries with sugar, raisins have a good effect.
Surgical intervention
If drug therapy did not bring the desired result, then surgical procedures may be prescribed for the treatment. The following types of intervention are indicated:
- mitral valve replacement;
- Morrow operation;
- commissurotomy;
- replacement or transplantation of the aortic valve ;
- coronary stenting.
Stenting is prescribed in case of myocardial ischemia. With aortic stenosis, adhesions are dissected on the valves. A similar technique allows you to slightly 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 cardiovert-defibrillator or pacemaker is sewn. 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 basically it happens rather unevenly. Coronary vessels are compressed. Angina pectoris is characterized by the presence of sternal pain of a pressing or compressive nature. In addition, the disease proceeds against the background of high blood pressure and a significant increase in heart rate.
Another dangerous complication is thrombosis. Due to insufficient blood pumping, blood clots form on the walls of the heart chamber and valves. They arise as a result of damage to the walls and subsequent sedimentation of red blood cells on them. Such a complication is very dangerous in that the thrombus can break off from its attachment site and clog the vessel.
If hypertrophy proceeds for a long time, then it can eventually become chronic. In this case, swelling is formed throughout the body. Patients cannot move normally due to severe dyspnea, poorly tolerate any load. In the later stages, a person is not even able to leave the house.
Forecast
The prognosis of the course of the disease is determined by the root cause of such a violation. At 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. Moreover, the quality of his life does not suffer.
In older people with myocardial ischemia, as well as previously suffered 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 human performance.