Doctors believe that if myocardial hypertrophy is asymptomatic, then everything can end with sudden cardiac arrest. It is scary when this happens to young and apparently healthy people who play sports. What happens during this disease, what consequences to expect and whether this pathology is treated is to be found in this article.
Pathology Description
It is called an autosomal dominant disease, which is transmitted mainly through heredity and mutation of genes that 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. The result of this is:
- the formation of sites of fibrosis;
- lesions of small coronary vessels;
- chaotic arrangement of muscle fibers;
- blood flow obstruction - displacement of the mitral valve, which prevents the ejection of blood from the atrium.
Ventricular myocardial hypertrophy is a rather serious disease.
In the presence of 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 increased volumes of work without increasing the load per unit mass. In this case, compensation will occur:
- increase in muscle mass of the myocardium;
- enhanced protein production;
- thickening of the walls;
- 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. A hypertrophied heart must adapt to new conditions. The myocardium thickens rapidly. In this case, the following occurs:
- blood supply disturbance;
- the effect of nerve tissue on metabolic processes changes;
- growth of nerves and capillaries lags behind;
- myocardial structures wear out;
- violation of repolarization;
- systolic, diastolic dysfunction appears.
Diagnosis of the 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, since in the absence of symptoms and complaints there is a heart attack, stroke, sudden cardiac arrest. In order not to cause any complications, you can not abruptly quit playing sports.
Hypertrophy in athletes has three types:
- Concentric hypertrophy - the myocardium increases, the cavity of the ventricles remains unchanged. Occurs in static sports and games.
- Eccentric hypertrophy is a proportional change in muscle. Characteristic for dynamic sports (long-distance running, skiing, swimming).
- Mixed hypertrophy - sports activities, which simultaneously use immobility and dynamics (bicycle, rowing, ice 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 front and rear walls thicken up to 18 years, then 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 disease usually have:
- myocardial dystrophy;
- angina pectoris;
- heart disease;
- hypertension.
Causes of Cardiomyopathy
It is necessary to separate the primary and secondary causes of hypertrophy. Primary causes:
- stress
- viral infections;
- alcohol consumption;
- heredity;
- overweight;
- excessive physical activity;
- toxic poisoning;
- drug use;
- pathological changes during pregnancy;
- micronutrient deficiency in the body;
- malnutrition;
- autoimmune diseases;
- smoking.
The secondary causes of myocardial hypertrophy include:
- Heart defects.
- Ischemic heart disease.
- Neuromuscular disease.
- Mitral valve insufficiency.
- Aortic stenosis.
- Arterial hypertension.
- Imbalance of electrolytes.
- Pulmonary disease.
- Parasitic processes.
- Violations of metabolic processes.
- Lack of oxygen in the blood.
- Damage to the interventricular septum.
- Endocrine Disorders
Let us consider in more detail the signs of left ventricular myocardial hypertrophy.
Left ventricular hypertrophy
Often, the pathology affects the walls of the left ventricle. The main reason is the 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, the following occurs:
- loss of myocardial muscle elasticity;
- violation of the normal functioning of the heart;
- slowing down blood circulation;
- there is a danger of sudden stress on the heart.
With left ventricular myocardial hypertrophy, the heart's need for oxygen and nutrients increases. It is possible to detect changes in left ventricular hypertrophy by instrumental examination. There is a syndrome of small release - fainting, dizziness. Symptoms that accompany hypertrophy:
- heartache;
- pressure drops;
- arrhythmia;
- angina pectoris;
- weakness;
- bad feeling;
- headache;
- shortness of breath at rest;
- palpitations with minor exertion;
- fatigue.
Hypertrophy of the right atrium
Thickening of the walls of the right ventricle is not a disease, it is an abnormality that occurs with overloads in this area. This happens as a result of the receipt of a large volume of venous blood from large vessels. These reasons may include:
- stenosis;
- congenital malformations;
- obesity;
- defects of the atrial septum, in which blood simultaneously enters the right and left ventricle.
With hypertrophy of the right ventricle, 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 on the stomach.
Hypertrophy of the interventricular septum
One of the signs of the development of the disease is hypertrophy of the interventricular septum. The main reason for this pathology is a gene mutation. Such hypertrophy provokes:
- atrial fibrillation;
- mitral valve disease;
- violation of the outflow of blood;
- ventricular fibrillation;
- ventricular tachycardia;
- heart failure;
- violation of the outflow of blood;
- cardiac arrest.
Symptoms of Heart Hypertrophy
The danger of heart myocardial hypertrophy is that often it passes without any symptoms. And the disease is usually diagnosed by chance at a physical examination. During the development of the disease, you can observe such signs:
- shortness of breath at rest;
- fainting
- chest pain
- fatigue
- heart rhythm disturbances;
- difficulty breathing
- drowsiness;
- swelling
- weakness;
- dizziness.
Signs of myocardial hypertrophy are important to be able to recognize in a timely manner.
Hypertrophy Classification
For convenience, specialists distinguish the following types of myocardial hypertrophy:
- symmetric - all walls of the left ventricle are affected;
- asymmetric - only one wall is affected;
- apical - increase the muscles of the heart from above;
- obstructive - in all areas, at the top of the septum;
- non-obstructive - mild symptoms, detected by chance.
Diagnosis of hypertrophic cardiomyopathy
At the first stages, with a slight development of hypertrophy, it is very difficult to identify the disease. The diagnostic process begins with a survey of the patient and usually find out the following details:
- past illnesses;
- the presence of pathologies in relatives;
- facts of radiation exposure;
- the death of a relative at a young age;
- external signs during visual inspection;
- indicators of blood and urine tests;
- blood pressure values.
There is such a new direction as the genetic diagnosis of myocardial hypertrophy. It will help to identify the parameters of GKMP, hardware and radiological methods:
- An ultrasound scan can evaluate myocardial thickening and impaired blood flow;
- An 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 myocardial thickness;
- Ventriculography determines contractile function.
Myocardial hypertrophy treatment
The main goal of treatment is to restore the previous size of the myocardium. The procedures that are aimed at this are carried out in a complex. More likely to cure hypertrophy if an early diagnosis has been performed. An important part in the myocardial treatment system is lifestyle. Doctors recommend following these rules:
- stop smoking;
- follow a diet;
- to lose weight;
- limit salt intake;
- exclude drugs;
- give up alcohol.
Treatment of left ventricular myocardial hypertrophy with a medication method includes taking medications that:
- correct heart rhythm disturbance (antiarrhythmics);
- reduce 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;
- liquid withdrawn - diuretics;
- with the threat of infectious endocarditis - antibiotic prophylaxis.
The doctor must select the drugs without fail. Self-medication is unacceptable and fraught with serious consequences.
What to do in the case of this pathology? An effective method of treatment that will allow you to change the contractions of the ventricles and the course of arousal is a two-chamber pacemaker. In more complex cases, with asymmetric hypertrophy of the MJP, latent obstruction, the absence of the effect of the drug, help to save the patient’s life:
- pacemaker implantation;
- excision of the share of the interventricular septum;
- defibrillator installation;
- transortic septal myectomy;
- transcatheter septal alcohol ablation.
Everything will depend on the degree of development of the pathology and the condition of the patient himself. We examined the symptoms and treatment of left ventricular myocardial hypertrophy.