1 What is What is this
Hypertrophy of the left ventricle( LV) implies increase in its cavity and walls due to internal or external negativefactors.
Typically, these include hypertension, the abuse of nicotine and alcohol, but mild pathology is sometimes found in people who exercise and regularly undergo heavy physical exertion.
The most informative method for determining this pathology is the electrocardiogram, which allows to identify the disease with an accuracy of 60-90%.
Norms of myocardial indices
There are a number of criteria for assessing the performance of the left ventricle, which in different patients may differ significantly. Decoding ECG consists in the analysis of teeth, intervals and segments and their compliance with the established parameters.
In healthy people without LV pathologies, the ECG decoding looks approximately as follows:
- In the QRS vector, which shows how rhythmically the excitation occurs in the ventricles: the distance from the first tooth of the Q to S interval should be 60-10 ms;
- The tooth S must be equal to the tooth R or be lower than it;
- The tooth is fixed in all leads;
- P wave P positive in I and II leads, VR negative, width - 120 ms;
- The internal deviation time should not exceed 0.02-0.05 s;
- The position of the electrical axis of the heart is in the range of 0 to +90 degrees;
- Normal conductivity on the left leg of the bundle.
Symptoms of abnormalities
In ECG, left ventricular hypertrophy of the heart is characterized by the following features:
- The mean QRS interval deviates forward and to the right relative to its position;
- There is an increase in the excitation going from the endocardium to the epicardium( in other words, an increase in the time of internal deviation);
- The amplitude of the tooth R is increased in the left leads( RV6 & gt; RV5 & gt; RV4 is a direct sign of hypertrophy);
- Teeth SV1 and SV2 significantly deepen( the more pronounced the pathology, the higher the teeth R and the deeper the teeth S);
- The transition zone is shifted to the lead V1 or V2;
- The segment S-T passes below the isoelectric line;
- Conductivity in the left leg of the bundle is broken, or complete or incomplete blockage of the foot is observed;
- Conductivity of the heart muscle is disrupted;
- Left-sided deviation of the electrical axis of the heart is observed;
- The electrical position of the heart changes to a semi-horizontal or horizontal position.
For more information about this condition, see the video:
Diagnostic measures
Diagnosis in patients with suspected LV hypertrophy should be performed on the basis of complex studies with the collection of anamnesis and other complaints, and on the ECG should be present at least 10 characteristicsigns.
In addition, doctors use a number of specific techniques to diagnose pathology by ECG results, including the ball system by Rohmilt-Estes, the Cornell symptom, the Sokolov-Lyon symptom, and so on.
If asymptomatic hypertrophy of the left ventricle is suspected, differential diagnosis with coronary insufficiency and myocardial infarction is very important.
Additional studies of
To clarify the diagnosis of LV hypertrophy, the physician can prescribe a number of additional studies, the most accurate being the echocardiography of .
As in the case of the ECG, a number of symptoms can be seen on the echocardiogram that may indicate LV hypertrophy - an increase in its volume relative to the right ventricle, thickening of the walls, a decrease in the value of the ejection fraction, etc.
If it is not possible to conduct a similar study, the patient may be assigned an ultrasound of the heart or an X-ray in two projections. In addition, to clarify the diagnosis sometimes required MRI, CT, daily monitoring of the ECG, as well as a heart muscle biopsy.
In what diseases does
develop? Hypertrophy of the left ventricle may not be an independent disease, but a symptom of a number of disorders, including:
-
Hypertension . The left ventricle can hypertrophy with both moderate and regular increases in blood pressure, since in this case, blood is pumped to the heart in an intensified rhythm, which causes the myocardium to thicken.
According to statistics, approximately 90% of pathologies develop precisely for this reason.
- Heart valve flaws .The list of such diseases includes aortic stenosis or insufficiency, mitral insufficiency, a defect of the interventricular septum, and often hypertrophy of the LV is the first and only sign of diseases. In addition, it occurs in diseases that are accompanied by a difficult exit of blood from the left ventricle into the aorta;
- Hypertrophic cardiomyopathy .Severe illness( congenital or acquired), which is characterized by thickening of the heart walls, as a result of which the exit from the left ventricle overlaps, and the heart begins to work with a heavy load;
- Ischemic heart disease .With IHD, LV hypertrophy is accompanied by diastolic dysfunction, that is, a violation of relaxation of the heart muscle;Atherosclerosis of heart valves .Most often, this disease manifests itself in the elderly - its main feature is narrowing the opening of the exit from the left ventricle into the aorta;
- Heavy physical activity .Hypertrophy of the left ventricle can manifest itself in young people, who often and intensively engage in sports, because due to heavy loads, the mass and volume of the heart muscle increase significantly.
Treatment of
Completely eliminate the pathology is impossible, therefore therapeutic methods are aimed at reducing symptoms, which is caused by cardiovascular disorders, as well as slowing the progression of pathology. Treatment is carried out by beta-blockers, angiotensin-converting enzyme( captopril, enalapril) inhibitors in combination with verapamil.
This therapy allows not only to stop the pathological process, but also to achieve some improvement in the state of the myocardium.
In addition to drug treatment, needs to monitor its own weight and pressure, stop smoking, drinking alcohol and coffee, and follow the diet of ( refusal of table salt, fatty and fried foods).In the diet must be present sour-milk products, fish, fresh fruits and vegetables.
Physical activity should be moderate , and emotional and psychological stress should be avoided whenever possible.
If LV hypertrophy is caused by hypertension or other disorders, the main treatment tactic should be aimed at their elimination. In advanced cases, patients sometimes require surgery , during which part of the modified cardiac muscle is removed surgically.
Whether this condition is dangerous and whether it should be treated, see the video:
Left ventricular hypertrophy - is a rather dangerous condition that can not be ignored by , because the left ventricle is a very important part of the great circle of blood circulation. At the first signs of pathology, it is necessary to consult with the doctor as soon as possible and to pass all the necessary studies.
