What is the danger of an increase in the left ventricle in the heart. Left ventricular enlargement of the heart: what is it, signs, diagnosis and treatment Left ventricular myocardial hypertrophy at the time of repolarization

Enlargement of the left ventricle of the heart: possible causes and treatment

Cardiovascular diseases are consistently linked and gradually exacerbate each other's severity. So, atherosclerosis gives rise to coronary disease, and hypertension - an increase in the left ventricle of the heart. These conditions simultaneously accelerate the development of heart failure, increase the likelihood of developing myocardial infarction or angina pectoris.
Some of the adverse events that lead to the appearance of cardiovascular diseases can be recognized at an age when their competent correction is possible. Therefore, special attention should be paid to such concepts as left ventricular hypertrophy (LVH) and dilatation, as well as to study the diseases in which they appear, to try to form a prognosis and tactics for their correction.

The concept of hypertrophy and dilation

Hypertrophy and dilatation are those morphological phenomena that lead to an increase in the size of the heart, mainly due to the left ventricle and atrium, less often due to the right ventricle of the heart. Hypertrophy is an increase in the left ventricle of the heart, thickening of the myocardium, primarily the interventricular septum and posterior wall, caused by physical training or diseases that disrupt intracardiac hemodynamics (malformations and hypertrophic cardiomyopathy) and afterload (hypertension). LVH is accompanied by an increase in stroke volume and an acceleration of contraction, allowing more blood to be pushed into the receiving vessels at higher pressure.

Dilatation - stretching and thinning of the walls of the myocardium, caused by a deterioration in the nutrition of the heart muscle and their inability to withstand the actual blood pressure inside the cavities, which is accompanied by an increase in LV filling and a significant decrease in its ejection fraction. This process inevitably follows severe hypertrophy due to its decompensation or appears primarily as a result of the development of dilated cardiomyopathy.

Detection of LV enlargement

An increase in the left ventricle of the heart, the causes of which will be indicated below, can be determined by a simple examination of the patient, during echocardiography, ECG, or x-ray diagnostics. Often this becomes an asymptomatic diagnostic finding when examining a patient for other reasons.
Signs of hypertrophy will be an increase in the percussion borders of the heart, a shift of the apex beat to the left and an expansion of its area, which can be determined during a medical examination. With dilatation, the percussion borders are also expanded, however, the apex beat is diffuse and weak, and may not be detected at all in overweight patients. So you can suspect an increase in the left ventricle of the heart (what is it from the point of view of medicine - read below).

Electro- and echocardiography

When an ECG is performed by a doctor functional diagnostics hypertrophy is often inferred from the calculation of standard indices based on the measurement of R and S wave voltages in chest leads. Dilatation of the cavities using ECG is determined indirectly on the basis of systolic overload, which cannot reliably indicate an increase in the left ventricle of the heart. Treatment only on the basis of the ECG in this case cannot be prescribed if it is not about concomitant arrhythmias.
An ECG in detecting structural pathologies of the heart is just one of the reasons to prescribe an ultrasound of the heart, which will make it possible to measure the size of the organ cavities and determine the thickness of the myocardium. In dilatation, the heart is dilated along with a decrease in wall thickness, and in hypertrophy, the myocardium thickens, often leading even to a decrease in the ventricular cavity.

X-ray diagnostics

Hypertrophy or dilatation, especially pronounced, can be determined by X-ray examination. Fluorography or radiography allows you to see the configuration of the heart. With hypertrophy due to aortic valve defect, a corresponding configuration is observed with the expansion of the left ventricle and the usual size of the atrium.
In the event of a defect mitral valve the configuration is very different: it shows atrial dilatation with a normal or only slightly enlarged LV. Hypertrophic cardiomyopathy can even be marked by a specific configuration, which, due to its large size, is called a "bull's heart." In dilated cardiomyopathy, x-rays show signs of aortic and mitral configuration, often associated with expansion of the right borders of the heart.

The role of LVH and dilatation in the development of CHF

The relationship between hypertrophy, dilatation, acute coronary syndrome, and congestive heart failure is direct and fairly easy to follow. As a result of long-term hypertension or the presence of an uncorrected defect, the normal myocardium hypertrophies and compensates for the influence of these diseases for a long time. With further increase in the left ventricle of the heart and atria, first transient and then permanent ischemia develops, which gradually leads to the death of myocardial cells. The result of this is a weakening of the walls of the heart, which is most pronounced in the left ventricle, causing pulmonary hypertension and first left ventricular, and then total heart failure with congestion in the circles of blood circulation.

Causes of LVH and dilation

All known causes of left ventricular enlargement must be clearly differentiated as factors in the development of either hypertrophy or dilatation. These morphological changes in the structure of the heart muscle have a different origin, but the same outcome, which depends on the degree of myocardial transformation. Among the causes of left ventricular hypertrophy are:

• physical strength and dynamic exercises, fitness;
• arterial hypertension;
• hypertrophic cardiomyopathy;
• compensated aortic stenosis or aortic insufficiency;
• compensated heart defects.

The causes of dilatation of the heart are much smaller, and they should be divided into primary and secondary. The primary ones include hereditary dilated cardiomyopathy, a disease associated with a defect in the structural proteins of muscle cells. For this reason, the myocardial wall cannot withstand the blood pressure inside the cavities of the heart, which is why it gradually stretches and becomes thinner. Secondary causes of dilatation include decompensation of congenital and acquired defects, acquired dilated cardiomyopathy (alcoholic, toxic or radiation).

Degrees of hypertrophy

Above is an explanation of the concept of what an increase in the left ventricle of the heart means, however, how it should be interpreted should be understood in more detail. If with dilatation the prognosis for the development of heart failure with a drop in ejection fraction is inevitable, then with LVH this can be avoided in most situations. Therefore, to form a prognosis, it is proposed to more fully assess the extent of hypertrophy according to echocardiographic criteria.

The normal thickness of the LV wall in women is 0.6 - 0.9 cm, and in men 0.6 - 1.0 cm in the region of the interventricular septum (IVS) and the posterior wall of the left ventricle (PLV).
With a mild degree of hypertrophy in women, there is a thickening of the LVW and IVS up to 1.0 - 1.2 cm, with an average degree of hypertrophy - 1.3 - 1.5 cm, and with a severe degree - more than 1.5 cm.
In men, a mild degree of LVH is observed when the thickness of the IVS and ZSLZh is within 1.1–1.3 cm, the average degree is 1.4–1.6 cm, and in severe cases it is 1.7 or more.

Physiological hypertrophy

Within the framework of sports medicine, there is such a thing as physiological functional hypertrophy caused by intensive training of the body, myocardium and skeletal muscles. This process allows for a stronger contraction of the heart and expulsion of a larger portion of blood into the receiving arteries, which guarantees intensive nutrition of the muscles of the body than in an untrained patient.
Physiological hypertrophy is the more pronounced, the harder the sport, and the more dynamic or static loads it requires. However, what distinguishes it from pathological hypertrophy is that it leads to an increase in the ejection fraction of the left ventricle of the heart. That is, a portion of blood that has entered the left ventricular cavity is pushed out more completely than in an untrained patient, faster and stronger. If in a healthy person the ejection fraction is approximately 65-70%, then in an athlete it can be 80-85% and higher.

This is what determines the ability of the heart to overcome intense physical activity. At the same time, physiological LVH rarely goes beyond the boundaries of a mild degree according to echocardiography, and is also characterized by a rich network of collaterals in the myocardium. Because of this, the risk of developing heart failure in the absence of other more important factors, such as hypertension, is quite low. In this case, hypertrophy is necessary to increase the fraction of the left ventricle of the heart, and not to overcome the total peripheral vascular resistance, as in the case of hypertensive hypertrophy.

Combined hypertrophy

If an athlete has hypertension, professional training should be stopped, since LVH will take on the character of not a compensatory mechanism, but a pathological one. The only reason inherent in the increase in the left ventricular ejection fraction of the heart will now work against the increase in exercise tolerance. There will be an increase in myocardial volume, after which the subepicardial areas will begin to experience constant ischemia. This will inevitably lead to the appearance of angina, will increase the risk of early development of myocardial infarction.

Treatment of LV enlargement

The debatable question of how to treat an enlarged left ventricle of the heart will not soon find an adequate unambiguous answer for the reason that this condition is not considered as a disease, with the exception of heart defects and dilatation. In hypertension, the main drugs that reduce pressure can prevent the development of LVH. All ACE inhibitors (Enalapril, Lisinopril, Quinapril, Ramipril), angiotensin receptor blockers (Candesartan, Losartan, Valsartan), diuretics (Indapofon, Hydrochlorothiazide) have this property. , Furosemide, Torasemide).

Prevention of LV hypertrophy

The doctor, prescribing a combination of drugs for the treatment of hypertension or heart failure, thereby achieves a slowdown in the development of hypertrophy and dilatation. This means that the prevention of hypertrophy is effectively achieved during the pharmacological treatment of hypertension, malformations, acute coronary syndromes and subsequent angina pectoris.

In situations where a certain heart defect has been identified in a patient, it is reasonable not to wait for the time of decompensation, when hypertrophy transforms into dilatation, but to correct the disease surgically. In the case of decompensation of hypertrophic (especially concentric or obstructive) or dilated cardiomyopathy, heart transplantation or temporary implantation of left ventricular prostheses is available to young patients.

Enlargement of the left ventricle of the heart: what is it, signs, diagnosis and treatment

The myocardium is the most important muscular layer of the heart. It is formed by special cells - cardiomyocytes. Such tissue exists in the atria and ventricles, but it contracts in a different way. The myocardium has its own conducting system, which explains the consistent work of various parts of the main muscle of the body. The disease of left ventricular hypertrophy of the heart can be both a precursor and a consequence of serious problems of the vascular system. It is about this pathology, its main causes and treatment options that will be discussed in today's article.

Medical certificate

Hypertrophy or enlargement of the left ventricle of the heart is a specific disease in which there is a thickening of the wall of the main muscle of the body. Normally, its thickness can vary from 7 to 11 mm. When this figure reaches 12 mm or more, they talk about the development of pathology.

The disease entails an increase in the volume of the heart muscle, problems with its full functioning. The consequences can be catastrophic, ranging from myocardial infarction to death. To prevent their occurrence, it is necessary to treat a hypertrophied organ in a timely manner. It is possible to completely overcome the disease only through surgical intervention.

The main causes of the disease

The reasons for the increase in the left ventricle of the heart are varied. Hypertrophy should not be considered a separate pathology variant, but a consequence of serious cardiac disorders. These are the following disorders:

What is this disease, many athletes know. Due to the serious physical exertion, their heart is almost constantly working in an enhanced mode. Hypertrophy is often found in overweight people. Against the background of obesity, the heart is forced to pump somewhat larger volumes of blood, resulting in its expansion. The causes of the disease, doctors also include an inactive lifestyle, the presence of bad habits. Hereditary predisposition plays an important role in the development of pathology.
Doctors refer to sleep apnea as an indirect cause. This violation is due to unconscious cessation of breathing during a night's rest. This period can last from a few seconds to 2-3 minutes. The disorder occurs in women in the postmenopausal period. It entails an increase in blood pressure and an increase in the load on the heart muscle.

Clinical picture

The reasons for the increase in the left ventricle of the heart, what it is - we considered these issues a little higher. What are the symptoms of the disease?

Signs of an increase in the left ventricle of the heart are not always clearly manifested. Often people are not even aware that there is a problem. If during pregnancy the fetus developed with abnormalities, hypertrophy is not excluded. Such cases must be observed from the very birth of the child and prevent the occurrence of complications.

Diagnostic methods

The disease can be recognized during a routine medical examination. The doctor should suspect hypertrophy already at the first examination. In patients with this diagnosis, cyanosis of the nasolabial triangle, rapid breathing, and severe edema are often observed. After the physical examination, a deeper examination is scheduled.
An increase in the left ventricle of the heart can be seen during:

After determining the cause and degree of development of the pathological process, treatment is selected.

Principles of therapy

How to properly treat an enlarged left ventricle of the heart, what it is, whether it is possible to prevent the disease - these questions should be answered by a cardiologist at the initial appointment. The treatment of this disease can be either medical or surgical. More details about each of the options will be discussed below.
However, the first thing it is recommended to start the fight against the disease is to eradicate all addictions. We are talking about smoking and alcohol abuse. Also, for some time you will have to follow a fairly strict diet. Its main purpose is to normalize blood pressure.
After consulting a doctor, you should diversify your usual lifestyle with cardiological stress. You can go to the pool or go for walks more often. Physical activity should not be excessive.

Taking medications

Treatment of an enlarged left ventricle with medications is effective only if the drugs are taken under the constant supervision of a physician. Completely stop the symptoms is not possible. However, the use of antihypertensive drugs allows you to deal with the cause of violations and prevent the development of complications.
For the treatment of hypertrophy, medications from the following groups are prescribed:

If the doctor has diagnosed an increase in the left ventricle of the heart in a child, the treatment is selected individually. Often drugs suitable for adults are ineffective and even dangerous for children.

Surgery

When an increase in the ventricle is provoked by heart defects, surgery is recommended. Surgical treatment can be of two types:

Help of traditional medicine

First of all, it should be noted that the recipes of folk healers should not be used as an alternative to traditional treatment. It can only be used as an addition to the prescribed course of therapy and to eliminate unpleasant symptoms.
For example, in the fight against chest pain, various herbal preparations have proven themselves well. St. John's wort, motherwort or cornflower flowers can be used as the main ingredient. Garlic honey is great for weakness. To prepare it, you need to mix honey and finely chopped garlic in a 1: 1 ratio, leave in a dark place for a week. It is recommended to take the remedy in a tablespoon three times a day, and it is better before the main meal.

Nutrition Features

With ventricular hypertrophy, all patients, without exception, are prescribed a strict diet. First of all, you need to exclude the consumption of fatty, fried and salty foods. You should also give up dairy products and foods with "fast" carbohydrates. The ban includes caffeinated drinks, sweet soda.
The daily diet should mainly consist of lean foods. It can be a variety of seafood, low-fat cottage cheese, kefir. Be sure to add more raw vegetables and fruits to your diet. From drinks, herbal teas and ordinary non-carbonated water are allowed.
Compliance with such a diet for only a few weeks allows you to normalize blood pressure, reduce the likelihood of developing ventricular hypertrophy of the heart.

What is the danger of the disease?

Moderate hypertrophy is not considered dangerous. This is a kind of compensatory reaction of the body, designed to improve blood circulation in organs and tissues. Most often, this form of disorder is observed in athletes.
Hypertrophy caused by pathological processes in the heart and blood vessels can provoke the following complications:
What threatens an increase in the left ventricle of the heart in the absence of adequate treatment? The most dangerous complication of the disease is the death of a person. That is why it is so important to periodically undergo a preventive examination, and if necessary, immediately begin therapy.

Prevention methods

Can left ventricular enlargement be prevented? What is this disease, we have already told. Now we need to consider the main ways to prevent it.

Standard prevention comes down to motivating the patient to a healthy lifestyle. To do this, he needs to eliminate all addictions, eat right and engage in feasible sports. If you have problems with the heart system, you will need to undergo an annual examination with a cardiologist and take prescribed medications.

What is the danger of an increase in the left ventricle in the heart

Left ventricular hypertrophy - pathological condition, characterized by the expansion and significant thickening of the walls of the main pumping chamber of the heart. It can form in any person in response to negative factors from the outside or against the background of internal diseases, for example, hypertensive pathology. An increase in the left ventricle of the heart is a potentially dangerous situation: it becomes the root cause of myocardial infarction.

The heart, as the main organ of every human being, bears a huge burden: to deliver blood with nutrients to every cell. Due to a number of negative internal and external factors, the left ventricle of the heart is forced to work in an enhanced mode, which first leads to thickening of the myocardium, and then to expansion of the entire chamber.
The main causes of hypertrophy:

• Most of the detected cases of enlargement of the heart sections occur in people suffering from hypertensive pathology: high blood pressure. It makes the heart work with a significant load, which is compensated by building up its own muscle mass.
• Formed aortic stenosis is another common root cause of forced expansion of the left ventricle. The organ has to exert considerable effort to push the flow of blood through the smaller diameter hole into the aorta.
• A genetically determined disease - hypertrophic cardiomyopathy is manifested by an initially thickened and stiff muscle in the heart.
• Professional sports. Intensive and prolonged loads lead to the fact that the cardiac structures cease to adapt and compensate for overwork in the organ: the left ventricle becomes pathologically enlarged.

Careful history taking and diagnostic procedures help specialists to identify the root cause of the pathological expansion of the heart chambers.

External and internal predisposing factors

Of the etiologically significant factors, experts indicate:

• various congenital or acquired heart defects;
• long-term experience of hypertensive pathology;
• negative hereditary predisposition;
• atherosclerotic lesions of the aorta;
• cardiomegaly and cardiomyopathy.

Predisposing negative factors also include an uncorrected diet, excessive passion for fatty, spicy, salty foods. If there are negative habits, for example, the abuse of tobacco, alcohol, narcotic products, this will affect the state of the heart muscle. Physical inactivity and chronic stress, as a result, can lead to failures and overloads in the cardiovascular system.

Complications of left ventricular hypertrophy

Carrying out preventive medical examinations with the obligatory passage of an ECG contributes to the early detection of a tendency to pathological expansion of the left chamber of the heart. With a significant expansion of the ventricle, its tissues are stretched and significantly weakened. This contributes to an increase in pressure in the organ, which ultimately leads to the following complications:

• complete interruption of blood flow with nutrients to the heart itself;
• the formation of severe insufficiency in the cardiovascular system;
• abnormal rhythm: various forms and types of arrhythmia;
• tendency to atrial fibrillation;
• the appearance of foci of ischemia in the tissue of the organ: coronary heart disease;
• dilatation of the aortic root;
• brain catastrophes - strokes;
• sudden complete cardiac arrest.

In the absence of adequate medical care, the pathological increase and thickening of the muscle fiber of the left chamber gradually ceases to be compensated, the above complications occur, up to death.

What to pay attention to

Failure in the structure of cardiomyocytes occurs imperceptibly for the person himself. For quite a long time, the heart muscle is able to compensate for this condition. This is indicated by the thickening of the wall of the left ventricle and the gradual expansion of its chamber.
Warning signs to watch out for include:

• more and more erratic breathing occurs;
• previously uncharacteristic fatigue, increased fatigue against the background of ongoing physical activity, without its increase;
• pain impulses in the region of the projection of the heart of varying severity and intensity, especially after training or overload;
• discomfort resembling flutter in the precordial region;
• emerging tendency to fainting, persistent dizziness.

Contact immediately for medical care recommended in the following cases:

• pain in the left side chest persists for more than 5-7 minutes and is not stopped by taking the usual medications,
• shortness of breath increases and is combined with tachycardia, or arrhythmia,
• the person often loses consciousness.

Most often, patients turn to specialists when they begin to be disturbed by already expressed pain conditions in the region of the heart, and the ECG reveals a significant expansion of its chambers.
However, timely seeking a consultation with a cardiologist in order to find out everything about the increase in the left ventricle of the heart, what it is, the subsequent conduct of adequate medical procedures contribute to the transfer of a negative state into a long-term remission or completely eliminates it.

Diagnostics

Adequate differential diagnosis is impossible without a comprehensive examination. In addition to a thorough history taking - family, professional, life - a specialist conducts a physical examination:

If preliminary studies indicate high risk left ventricular tissue hypertrophy, the following screening tests are recommended:

• difficulty in the passage of impulses through the tissues of the heart during an ECG can indirectly indicate LV hypertrophy;
• ECHO KG helps to assess the blood flow and parameters of the organ;
• in doubtful situations, when additional clarification of the possibility of a formed pathology in the heart is required, CT, MRI of the organ is recommended for carrying out.

Of the additional methods: chest x-ray, PET diagnostics.
Only all the completeness of information from the above diagnostic procedures allows the cardiologist to conduct an adequate differential diagnosis and navigate in ways to get rid of the negative state.

Treatment tactics

The therapeutic course is largely determined by the root cause: what pathology contributed to the formation of hypertrophy and an increase in the parameters of the left ventricle.

It may include not only pharmacotherapy, but also surgery, for example, in case of aortic valve stenosis, it is replaced.
To improve the effectiveness of the ongoing treatment tactics, a prerequisite is the timely identification and subsequent elimination of risk factors:

And only after all of the above, the specialist will recommend drugs that have the ability to reduce the parameters of the left ventricle. Many of them are already prescribed by a cardiologist at the stage of correction of hypertension:

• ACE inhibitors;
• angiotensin receptor blockers;
• diuretics;
• beta blockers.

Calcium antagonists also help.
In the absence of a positive effect and in the detection of changes in the structure of the heart - various deviations in the activity of the valves - surgical intervention is required.
This issue is decided in each case individually.

Prevention

Of the measures that help prevent pathological thickening of the myocardium and an increase in the size of the heart chamber, experts indicate the following:

• lifestyle changes, the pursuit of a healthy style;
• weight reduction;
• exclusion from the diet of salty, spicy, smoked, fatty and heavy foods, preservatives and sauces;
• long walks in the fresh air;
• ensuring a quality night's rest in a well-ventilated area;
• avoidance of stressful situations.

Another important event is the annual preventive medical examination. It is it that helps to identify and eliminate all failures in the activity of the heart in time.

Enlargement of the left ventricle of the heart: signs, diagnosis, treatment

Many people are interested in: an increase in the left ventricle of the heart - what is it? This term refers to the adaptation of an organ to the influence of various factors. In a child, the deviation may be due to congenital malformations. In adulthood, the disease is often associated with hypertension, which occurs under the influence of bad habits and excess weight. Such an anomaly can threaten hemodynamic disturbances, which leads to various complications. Therefore, hypertrophy therapy should be started immediately.

Process features

What does an increase in the left ventricle of the heart muscle mean? This deviation is associated with the presence of a hypertrophied wall, which provokes a violation of the structure of the interventricular septum. The increase in its size has a uniform or localized character. At the same time, the internal part of the body remains unchanged.

Doctors distinguish 2 types of anomalies:

• concentric hypertrophy - due to the effect of increased pressure;
• eccentric form - associated with an overload of the ventricle with a large amount of blood.

With an increase in the left ventricle, the threat of dangerous health consequences increases. These include strokes, ischemic disease, aortic enlargement. With such a deviation, there are palpitations, heart failure, arterial stenosis, fainting.
The appearance of complications is due to the loss of elasticity of the left ventricle, due to its thickening. As a result, pressure in the heart may increase, provoking serious hemodynamic disturbances. The proliferation of heart tissue leads to compression of the coronary vessels. This leads to malnutrition of the myocardium.

Causes of thickening of the wall of the ventricle

If the left ventricle of the heart is enlarged, the causes and consequences of this condition are diverse. The following factors lead to the appearance of this disease:

The threat of proliferation of heart tissue may increase under the influence of such factors:

Minor hypertrophy is often diagnosed during pregnancy. The heart is forced to pump more blood, which leads to an increase in the ventricle. The process stops after the birth of the child.

Symptoms of an enlarged heart

Signs of an increase in the left ventricle are observed only in advanced situations with the appearance of complex blood flow disorders and cerebral hypoxia.
Patients attribute the first manifestations of the disease to ordinary fatigue. However, as the disease progresses, the symptoms become more pronounced. These include:

There are manifestations that pose a real danger to life. It can be:

• pain in the heart for more than 5 minutes;
• tachycardia;
• shortness of breath, which develops into suffocation;
• deterioration of cognitive functions - memory, intelligence;
• permanent loss of consciousness.

Important: The listed symptoms indicate the development of dangerous complications. To cope with them, you need to immediately consult a doctor.

Diagnostics

Routine examinations allow to identify pathology. Most often, an anomaly is diagnosed in people who are professionally involved in sports and annually undergo a detailed examination.
Echocardiography allows detecting pathology, which involves examining the chambers of the heart using an ultrasound device. This procedure is often carried out with arterial hypertension. Also, the study is prescribed for dizziness, pain in the chest, general weakness, shortness of breath.
If during the echocardiography a thickening of the walls of the ventricle was detected, additional procedures are performed. They will help determine the cause of the problem. Such studies include the following:

How to treat an enlarged left ventricle? To cope with the pathology, you need to establish the provoking factor of the violation. Therapy includes the use of medications and surgery.
For the treatment of pathology, the following categories of drugs are usually used:

If the cause of the pathology is heart defects, it will not be possible to do without surgical intervention. It can be of two types:

If the cause of hypertrophy is hypertension, folk remedies can be used. However, before using them, you should consult your doctor.
Effective recipes include the following:

Complications

Pathology can lead to dangerous consequences. These include:

• arrhythmia;
• heart attacks;
• ischemia;
• heart failure;
• cardiac arrest.

Prevention

To avoid problems, you need to follow these recommendations:

• eliminate the influence of stress factors;
• do sport;
• sleep well;
• give up bad habits - drinking alcohol and drugs, smoking;
• Healthy food.

An important component of the prevention of left ventricular enlargement is diet. To do this, you need to follow these recommendations:

Important: With a tendency to ventricular hypertrophy, it is worth walking a lot every day. This will provide the heart with the necessary amount of oxygen and improve the human condition.
Be sure to eliminate the effect of risk factors. To do this, you need to fight excess weight and control pressure parameters. Equally important is the control of health status with the help of medicines. For this you need:

• maintain normal sugar levels;
• take medication to prevent blood clots;
• stop using oral contraceptives.

Left ventricular enlargement is a dangerous disorder that can lead to negative health consequences. To cope with the problem, it is necessary to consult a doctor in a timely manner. In simple cases, the use of medications is sufficient. If the disease progresses, surgery may be necessary.

What to do if the left ventricle of the heart is enlarged?

Pathological changes in the structure of the heart can be diagnosed using modern methods. One of the most effective recognized electrocardiogram. A direct indication for this examination may be a pronounced clinical picture a life-threatening condition for the patient, when a person feels constant malfunctions in the work of the heart, as well as pain in the area of ​​\u200b\u200bthe organ. Timely response is important not only for doctors, but also for the patients themselves. Multiple diseases that develop due to impaired blood flow in the body are often the cause of death.

Features of the pathology

Enlargement of the left ventricle of the heart: what is it? This is a complex and dangerous pathology that clearly requires medical treatment. The disease develops due to other violations of the functioning of some organs, including the heart. Any interventions by doctors are carried out only on the basis of the results of a thorough diagnosis of the patient's health.

According to statistics, almost four percent of patients with this diagnosis die. The probability of death increases when dangerous symptoms are ignored and the patient himself does not accept the importance of this factor. What is it and why should you pay attention to the signs of the disease? Doctors emphasize that patients with hypertension are at risk. High blood pressure is most often the result of a change in the size of the left ventricle.
The norm is considered to be the thickness of its walls 11-14 mm., And the volume is up to 210 cm3. This organ contracts blood and helps push it into the aorta. Violation of this function leads to a deterioration in blood circulation in a large circle, which begins precisely from the left ventricle. Uneven blood flow to the liver, kidneys, brain, limbs and stomach provokes a violation of the activity of these organs.
Often, the patient begins to develop complex diseases, the treatment of which must begin with the restoration of normal blood circulation.
The left ventricle enlarges due to wall thickening.
The process can manifest itself uniformly or localized. Cardiologists subdivide the development of pathology in two directions:

• The concentric type is characterized by thickening of the walls of the ventricle due to functional pressure.
• Eccentric type, it is determined by the volume load.

Doctors do not attribute an increase in the left ventricle to diseases, considering it a specific abnormal deviation. As a result of many years of research, it was found that with long-term defects, not only the left ventricle, but also the atrium can increase. Less commonly, hypertrophy affects the entire heart.

Provoking factors

An increase in the left ventricle of the heart can be the result of not one cause, but a whole set of provoking factors. The age of the patient, hereditary features, body weight and living conditions matter. In exceptional cases, an increase in the ventricle can be defined as a variant of the norm. It happens during physical exertion, during the period of bearing a child, less often - during puberty.
Significant changes, in any case, are considered as a pathological process. The leading causes affecting the size of the ventricle are as follows:

It is important to know that any negative processes in the human body can lead to an increase in the left ventricle of the heart. Unnatural state chronic diseases causes heart failure. It is not excluded the formation of pathology with constant emotional stress of a negative nature.
On the initial stage the development of the pathology of the patient, as a rule, does not notice dangerous signs.
Symptoms begin to appear when the left ventricle is already enlarged to a large extent. Cardiologists recommend paying attention to the following changes:

• pain in the chest area;
• sudden fainting;
• dyspnea;
• fast fatiguability;
• cardiopalmus;
• dizziness.

The patient can live with an enlarged ventricle for more than one year, without feeling any special health problems. However, a sharp increase in the ventricle, which is possible at any stage, provokes sudden angina pectoris, atrial fibrillation. General well-being worsens, sleep is disturbed. Nosebleeds can be accompanied by an increase in blood pressure, which means that there is a high probability of a change in size.

Consequences

Irreversible consequences for the structure of the heart can have untimely treatment and ignoring dangerous symptoms. Even a slight increase causes the development of a complex pathology, leading to an increase in pressure inside the organ. Affected tissues compress the blood vessels, as a result of this, blood flow directly to the heart muscle itself is limited.
In a situation where the heart is enlarged to the left, a number of complications develop:

It should be noted that ventricular hypertrophy leads to significant deterioration of the heart. The development of the disease, regardless of the reasons, catastrophically worsens the state of health, and an appeal to a cardiologist is simply a vital necessity. The average data suggests that this heart disease can provoke complications with a too active lifestyle.
One of the most important factors in identifying pathological processes affecting the heart is the history of the patient's lifestyle and the presence of chronic diseases.
A special role in the increase in the left ventricle of the heart is played by hereditary predisposition.
Doctors recommend not to lose sight of the risk of cardiovascular diseases transmitted at the genetic level. This will not only help to pay attention to dangerous symptoms, but also quickly diagnose any disorders, thereby avoiding a possible heart attack or sudden cardiac arrest.

The following sources of information were used to prepare the material.

Left ventricular enlargement (or hypertrophy) is the expansion and thickening of the walls of the main pumping chamber of the heart. Hypertrophy can develop in response to some negative factor, such as high blood pressure or significant physical exertion. The enlarged heart muscle loses elasticity and eventually cannot pump blood with the necessary force. Left ventricular enlargement is most common in people who have uncontrolled high blood pressure. This condition is quite dangerous, because it can eventually lead to the development of a heart attack and stroke. Older people with overweight, hypertension and diabetes are at risk.

Symptoms of the development of an abnormal condition

Expansion of the left ventricle in most cases develops very slowly. The patient may not experience unpleasant signs or symptoms, especially in the early stages of the disease. But as hypertrophy develops, there may be:

• erratic breathing;
• unexplained fatigue;
• chest pain, especially after exercise;
• feeling of fast, fluttering heartbeats;
• dizziness or fainting.

You need to seek medical attention if:

• there is a feeling of chest pain that lasts longer than a few minutes;
• there are serious breathing difficulties that interfere with daily life activities;
• have serious recurring memory problems;
• there are loss of consciousness;
• worried about shortness of breath in combination with palpitations.

Reasons for the development of the anomaly

An increase in the left ventricle can occur if some unfavorable factor makes the heart work harder than usual. This means that the heart muscle will need to make several times more contractions in order to pump blood around the body.

Reasons that can provoke a significant deterioration in the work of the heart:

• High blood pressure (hypertension) is considered the most common cause of thickening of the ventricular wall. More than one-third of all patients become aware of hypertrophy at the time of diagnosis of hypertension.
• Aortic valve stenosis is a narrowing of the muscle tissue that separates the left ventricle from the aorta. Narrowing of the aortic valve causes the heart to contract several times more often in order to pump blood into the aorta.
• Hypertrophic cardiomyopathy is genetic disease, which occurs when the heart muscle becomes abnormally thick and stiff.
• Professional sports. Intense, long-term strength training, as well as irregular endurance exercises, can cause the heart to not be able to quickly adapt and cope with the additional load. As a result, the left ventricle may swell (enlarge).

What can hypertrophy lead to?

The disease cannot be ignored, because a significant increase in the ventricle can greatly change the structure and functioning of the heart. An enlarged ventricle can weaken and lose elasticity, which increases pressure in the heart. Hypertrophied tissue can also constrict blood vessels and restrict blood flow directly to the heart muscle.

As a result of these changes, the following complications may occur:

• complete interruption of blood supply to the heart;
• the inability of the heart to pump enough blood around the body (heart failure);
• abnormal heart rhythm (arrhythmia);
• irregular heartbeat (atrial fibrillation);
• insufficient supply of oxygen to the heart (ischemic heart disease);
• expansion of the aorta (dilatation of the aortic root);
• stroke;
• sudden deterioration in heart function (sudden cardiac arrest);
• sudden loss of consciousness.

The consequences of hypertrophy can be called catastrophic for health, so if the patient has identified the causes of the development of the disease, it is necessary to contact a cardiologist.

Diagnostic methods

Before making a diagnosis, the doctor will take a medical history and perform a thorough physical examination, including measuring blood pressure and testing heart function. If preliminary studies indicate that the ventricle may indeed be enlarged, a number of additional screening tests are performed.

Electrocardiogram (ECG)

The electrical signals will not be able to confirm the enlargement of the ventricle. But cardiologists can identify some difficulties in the passage of the impulse, which will indicate a violation of the density of the muscle tissue of the heart.

MRI

Images of the heart made by a special tomograph will directly indicate ventricular hypertrophy.

Treatment of hypertrophy

Treatment depends on the underlying cause of the enlarged ventricle and may include medication and/or surgery.

The most common medications that are prescribed for hypertrophy are as follows.

Angiotensin-converting enzyme (ACE) inhibitors

These drugs dilate blood vessels, lower blood pressure, improve blood flow, and help reduce the heart's workload. Trade names drugs: captopril, enalapril and lisinopril. The most common side effect is a persistent, irritating dry cough.

Angiotensin receptor blockers

These medications are analogous to ACE inhibitors, but do not cause a persistent cough.

Beta blockers

Beta-blockers help lower your heart rate and normalize your blood pressure. Beta-blockers are not usually prescribed as the primary treatment for hypertrophy.

Diuretics

Thiazide diuretics help improve blood flow to the heart and lower blood pressure. Trade names: chlorthalidone and hydrochlorothiazide.

Surgical treatment consists in repair or complete replacement of the aortic valve.

Prevention of hypertrophy

Lifestyle changes can help not only prevent the development of hypertrophy, but also improve the condition of an already enlarged ventricle. Since hypertrophy is common in people suffering from obesity, maintaining an ideal body mass index will be the best prevention of the disease. It is also worth limiting the amount of salt in the diet to normalize blood pressure. If hypertrophy is suspected, it is recommended to drink alcohol in moderation, and if treatment is prescribed, then it is better to refuse strong drinks altogether.

Despite the fact that one of the reasons for an increase in the ventricle of the heart is heavy physical exertion, you should not give up sports. Regular physical exercise, such as walking, Pilates, yoga, not only will not harm, but on the contrary will strengthen the heart. If the diagnosis of hypertrophy has already been made, it is necessary to ask a physiotherapist to select the optimal exercise programs. 30 minutes of moderate physical activity will strengthen a weakened heart muscle and prevent its increase.

A healthy lifestyle and proper nutrition will allow you to forget about problems with the left ventricle for a long time.

What are the features and causes of heart enlargement?

With an increase in the heart, or in another way it is referred to as cardiomegaly, there is an expansion of one or all four heart chambers - this is the right ventricle and right atrium, left ventricle and left atrium. Depending on the severity of organ hypertrophy, the degree of damage and loss of functional features are distinguished, which can lead to the development of various complications.

Cardiomegaly or heart enlargement?

Hundreds of thousands of people die every year from cardiovascular pathologies. In most cases, the reason for this is the untimely visit to the doctor and the deterioration of the state of cardiac activity.

An increase in the body is associated with the development of ventricular hypertrophy, the accumulation of metabolic products and neoplastic processes. Cardiomegaly often occurs in healthy people, including athletes and pregnant women.

The volume of the heart varies from person to person. If we talk about gender differences, then in men this organ is larger than in women. So for the age category from 20 to 30 years, the approximate volume of the heart will be the following values:

• women - 580 cm3;
• men - 760 cm3.

Also, this figure depends on body weight. It is necessary to make a diagnosis of cardiomegaly only after a thorough examination, because in some cases a small enlarged heart is the norm, which is strictly individual for each person.

Expansion of the right or left ventricle: causes

An increase in the walls of the right or left ventricle is called hypertrophy. In this case, there is a violation of the functioning of the myocardium and, as a result, their functional activity worsens. Depending on the localization of the depletion of the heart muscle, a different etiology is also distinguished.

Right ventricular hypertrophy

An increase in the walls of the right ventricle is most often observed in children with congenital defects in fetal development. Also, one of the main reasons is associated with an increase in pressure in the pulmonary circulation and the discharge of blood into the right ventricle. In this case, there is an increase in the load of the right ventricle.

In adults, the cause of right ventricular hypertrophy is more often diseases that prevent normal breathing. These include the following pathologies:

• rachiocampsis;
• diseases of the pulmonary vessels (compression, embolism, thrombosis, etc.);
• bronchial asthma;
• tuberculosis;
• bronchiectasis;
• Chronical bronchitis;
• poliomyelitis, etc.

Left ventricular hypertrophy

Left ventricular hypertrophy is dangerous with sudden cardiac arrest, the cause of myocardial infarction and death. Thickening of the walls of the left ventricle can be the result of such cardiac pathologies:

• developing atherosclerosis of the aorta;
• hypertonic disease;
• congenital or acquired heart defects;
• obesity.

In order to prevent the development of such serious diseases, it is necessary to follow preventive measures, which means adhering to a healthy lifestyle and being observed by a doctor in order to diagnose all violations in a timely manner.

Causes of cardiomegaly

Most often, an increase in the heart in diameter is diagnosed in adults. The predisposing factors that contribute to the expansion of the boundaries of the shadow of the ventricles and atria are quite diverse, in most cases this is associated with cardiovascular pathologies. So, the following reasons can be attributed to the etiology of the appearance of cardiomegaly:

• excessive sports;
• pregnancy;
• idiopathic cardiomyopathy;
• heart defects;
• anemia in severe forms;
• infectious diseases, where the target organ is the heart muscle;
• complications after viral diseases;
• ischemia or myocardial infarction;
• inflammatory processes in the heart;
• strong stress loads;
• excessive alcohol consumption, drug addiction, smoking;
• kidney disease and kidney failure;
• rheumatic heart disease and endocarditis;
• hypertension, etc.

If an increase in the heart muscle is detected, the doctor prescribes the necessary diagnosis and treatment.

Clinical manifestations

With the expansion of the heart in diameter or in other departments, the patient may experience unpleasant symptoms. This includes the following clinical manifestations:

• increased fatigue;
• shortness of breath at rest or with minor physical exertion;
• increased blood pressure;
• appearance pain in the region of the heart;
• edema formation in lower limbs;
• headaches and dizziness;
• short-term loss of consciousness.

Other signs characteristic of a particular cardiac pathology, if any, may also join.

Treatment

During treatment, it is important to identify the focus, which means to determine the disease or disorder that provoked the occurrence of heart enlargement. As soon as this is diagnosed, treatment is prescribed to eliminate this pathology.

As an auxiliary therapy, medications are prescribed, the purpose of which is to reduce the barrier to normal blood outflow while unloading the increased work of the ventricles. This will prevent the risk of complications in the form of myocardial infarction, angina pectoris, shortness of breath and arrhythmia.

If therapeutic actions are ineffective, the doctor may prescribe surgery to improve blood flow. However, they resort to it only in extreme cases.

1. You should stop drinking alcoholic beverages, which have a toxic effect on the myocardium (heart muscle).
2. In order to prevent the deposition of cholesterol plaques on the walls of blood vessels, foods high in cholesterol should be excluded from the daily diet. It is advisable to consume fish, olive, flaxseed, corn and soybean oils at least 2 times a week.
3. To strengthen and maintain the heart muscle in normal working condition, it is useful to include viburnum, cranberries, cabbage, eggplant, peaches, dried apricots, apples, pomegranate, walnuts, melons, etc. in the daily diet.
4. It is necessary to reduce salt intake to at least 2 grams. per day, especially for patients with increased swelling.
5. With fixed obesity, it is necessary to draw up a proper balanced diet aimed at eliminating extra pounds.
6. Sleep at least 8 hours, physically and emotionally do not overwork.
7. More often walk in the fresh air.

Heart enlargement is not a diagnosis, but only a temporary condition of the heart muscle. With the right and timely actions, this violation can be eliminated and significantly alleviate your condition.

Cardiac hypertrophy, or, in other words, hypertrophic cardiomyopathy, is a thickening of the wall of the left ventricle of the heart, which leads to malfunction of the aortic valve. The problem is common among patients with hypertension, as well as athletes, people leading a sedentary lifestyle, alcohol addicts and those who have inherited a tendency to pathology.

Hypertension of the myocardium of the left ventricles of the heart belongs to class 9 on the ICD 10 scale, along with other diseases of the circulatory system. This pathology is mainly a syndrome of other heart diseases, the indirect signs of which are manifested. To prevent possible problems in the future, it is necessary to intensively treat the hypertrophied organ in a timely manner, immediately after the detection of pathologies.

Depending on the signs of LVH and the size of the deformed muscle tissue, several stages of the development of the disease can be distinguished:

Moderate left ventricular hypertrophy (LVH) occurs as a consequence of hypertension or other heart disease. This seemingly insignificant increase indicates an overload of the heart and that the risk of myocardial diseases (heart attack, stroke) for the patient increases. Often proceeds without any signs, is found only in the analysis of the ECG. If the left ventricle is enlarged, it is necessary to be treated with the help of specialists, best of all - permanently.

Severe LVH is characterized by dystrophic changes in which the mitral valve is located close to the surface of the septum and interferes with blood flow, causes excessive muscle tension and stress on the left ventricle.

The causes of left ventricular hypertrophy of the heart can be varied, including both chronic and acquired diseases of different parts of the body:

• hypertension;
• obesity: the development of the disease in young children who are overweight is very dangerous;
• ischemia;
• diabetes;
• arrhythmia, atherosclerosis;
• frequent excessive physical activity;
• alcoholism, smoking;
• high blood pressure;
• lung diseases;
• aortic stenosis;
• violations of the mitral valve;
• stress, psychological illness, nervous exhaustion.

The development of the organism in a child can proceed with a violation of the processes of myocardial repolarization and, as a result, an increase in the walls of the ventricle. If such a situation has arisen, it must be prevented, and in the future to be observed stationary throughout growing up and to prevent progression. Constant exercise can naturally lead to heart enlargement, while heavy lifting is a potential threat of systolic overload, so you should normalize your physical activity and monitor your health.

Another indirect cause is sleep disturbance, in which a person stops breathing for a short period of time. It can be observed in women during menopause or in the elderly and entails such consequences as the expansion of the diameter of the vessels of the heart, the growth of the septum and walls of the heart, increased blood pressure, arrhythmia.

The symptoms of cardiomyopathy are not always obvious, and often people are unaware that there is a problem. If during pregnancy the fetus did not develop correctly, there may be a congenital defect and hypertrophy of the left heart. Such cases must be observed from birth and prevent complications. But if there are periodic interruptions in the work of the heart and a person feels any of these signs, perhaps the walls of the ventricle are not in order. The symptoms of this problem are:

• labored breathing;
• weakness, fatigue;
• chest pain;
• low heart rate;
• swelling of the face in the afternoon;
• disturbed sleep: insomnia or excessive sleepiness;
• headache.

If the left ventricle is hypertrophied, this is not a disease, but it can provoke a lot of them in the future, including the death of heart attacks, strokes, angina pectoris and other heart ailments. Often an increase in the organ occurs due to an active lifestyle, in athletes, when the heart works harder than in the average body. Such changes may not pose a threat, but in each individual case, qualified consultation and advice from a doctor is necessary.

Diagnosis of left ventricular hypertrophy occurs in several ways: it is the identification of signs of the disease on the ECG, examination of the heart by ultrasound or using a magnetic resonance imaging scanner. If you have any heart problems and symptoms of the disease, you should contact a cardiologist, and if you have already suffered some kind of defect and suspect complications, you need a heart surgeon and, possibly, a treatment system.

ECG is a common diagnostic method that helps to find out the thickness of the heart muscle and voltage signs. However, detecting LVH on an ECG without the involvement of other methods can be difficult: an erroneous diagnosis of hypertrophy can be made, since ECG signs, which are characteristic of it, can be observed in a healthy person.

LVH on ultrasound

Ultrasound procedure helps to more likely judge individual factors and causes of hypertrophy. The advantage of ultrasound is that this method allows not only to diagnose, but also to determine the features of the course of hypertrophy and the general condition of the heart muscle. Cardiac echocardiography indicators reveal such changes in the left ventricle as:

• ventricular wall thickness;
• the ratio of myocardial mass to body weight;
• coefficient of asymmetry of seals;
• direction and speed of blood flow.

MRI of the heart

Magnetic resonance imaging helps to clearly calculate the area and degree of enlargement of the ventricle, atrium or other compartment of the heart, to understand how strong dystrophic changes are. MRI of the myocardium shows all the anatomical features and configuration of the heart, as if “stratifying” it, which gives the doctor a complete visualization of the organ and detailed information about the state of each department.

Many people are susceptible to cardiac hypertrophy. If the problem is severe, medical or surgical treatment of left ventricular hypertrophy is performed. At the same time, depending on the degree of damage, treatment can be aimed at preventing the progression of the disease or at returning the myocardium to normal sizes. But it happens that this condition is reversible, if the disease cannot be completely cured, then regression can be achieved by correcting such things as:

• Lifestyle;
• type of food;
• hormonal balance;
• excess weight;
• number physical activity.

Medicines for left ventricular hypertrophy of the heart can have an effective result if taken under the supervision of a physician. It is impossible to completely eliminate the symptoms of hypertension, however, taking antihypertensive drugs for this disease and following a diet will help fight the causes and prevent deterioration of health. To cure LVH, the following medications are prescribed:

Verapamil is an angioarrhythmic agent from the group of calcium channel blockers. Reduces myocardial contractility, reduces heart rate. Can be used by both adults and children, doses are set individually.

Beta-blockers - reduce the load of pressure and volume in the heart cavity, help to equalize the rhythm and reduce the risk of a defect.

Sartans effectively reduce the overall load on the heart and remodel the myocardium.

Myocardial hypertension of the left heart belongs to class 9 on the ICD-10 scale, along with other diseases of the circulatory system. Preference should be given exclusively to drugs whose quality has been tested and proven clinically; experimental drugs may not only not have the expected effect, but also adversely affect all health in general.

Surgery for left ventricular hypertrophy may be needed to remove the hypertrophied muscle in the late and advanced stages of the disease. For this, a transplant of the whole heart or its individual parts is performed. If the cause of LVMH is damage to a valve or septum, transplantation of these specific organs is first attempted, which is simpler than whole heart surgery.

Treatment of left ventricular hypertrophy folk remedies cannot help in the later stages of lesions, but can be effective with slight increases, to prevent their development, reduce the risk of more serious consequences. You will not be able to completely cure the disease, but traditional medicine can alleviate discomfort, chest pain, weakness and fainting. Known means are:

Herbal preparations as adjuvant therapy in the main treatment (blueberry, motherwort, bogulnik hawthorn, horsetail, cornflower flowers, adonis)

Infused milk: boil and pour into a thermos overnight, or put in the oven until a brown crust forms.

Lily of the valley in the form of drops of tincture or gruel. For tincture, pour lily of the valley with vodka or alcohol, insist in a dark place for 2 weeks, take 10 drops 3 times a day for 2 months. Porridge: pour boiling water over lily of the valley flowers, leave for 10 minutes. Then drain the water, grind the plant and take a tablespoon 2 times a day. Recommended in combination with drops.

Garlic honey: mix crushed garlic with honey in proportions of 1:1, leave for a week in a dark place, take 1 tablespoon 3 times a day before meals.

Dry red wine infused with dried rosemary. Pour the leaves with wine, leave for about a month in a dark place, strain and take before meals.

Cranberries mashed with sugar: 1 teaspoon 4 times a day.

To adjust the diet for cardiomyopathy, follow these tips:

• give up salt;
• eat often, about 6 times a day, but in small portions;
• quit smoking, drink less alcohol;
• choose foods that are lower in fat and cholesterol;
• limit the amount of animal fats;
• sour-milk, dairy products, fresh vegetables and fruits are useful;
• eat less flour and sweets;
• if you are overweight - follow a diet to lose weight and reduce the load on the heart.

The main treatment for left ventricular hypertrophy is to improve myocardial function with the help of medications. If the condition worsens and the drugs do not work, surgery is performed. During the operation, the septum is given a normal physiological shape. If you start treating hypertrophy in time, you can live for many years. You can even endure and give birth to a baby. The only thing that is prohibited for patients with hypertrophic cardiomyopathy is hard physical labor.

Radical surgical treatment for this heart disease has not been developed. The choice of palliative surgery depends mainly on the state of the pulmonary circulation. With a sharply increased pulmonary blood flow in the early childhood apply the operation of narrowing the pulmonary artery, and with reduced pulmonary blood flow - the imposition various kinds interarterial anastomoses or cavapulmonary anastomosis. In patients with a normal location of the great vessels or dextrotransposition of the aorta, it is preferable to impose an intrapericardial anastomosis between the ascending aorta and the right branch of the pulmonary artery, and in case of sinistrotransposition, an intrapericardial anastomosis between the ascending aorta and the left pulmonary artery (V. P. Podzolkov, 1972).

How to treat an additional chord of the left ventricle in a child?

As a rule, additional chords can be detected in a child shortly after his birth or in the period before his adulthood. But, since this anomaly manifests itself weakly or almost neutrally, most people may not even be aware of their diagnosis. A person can learn about this feature of the structure of his heart only after a thorough prof. medical examination or as a result of treatment for a completely different disease, which worries him much more.

If you think that by making a cardiogram of the heart, you will get answers to all your questions, then you are mistaken. No ECG is able to make a detailed diagnosis of the structure of your child's heart.

How should parents behave after they heard that their baby has additional chords in the heart? Of course, it is important to have information on this issue and know which specialist to contact in this case. Next, we will talk about why such a cardiac anomaly may occur.

In addition, the chord is sometimes fixed as apical, median, or basal. Filiform strands are both in the singular and in the plural.

• The head is spinning;
• Weakness and lethargy;
• High heart rate;
• Failures in the heart rhythm;
• Heart hurts;

There are times when, after a period of growing up, the above symptoms disappear. But sometimes the external manifestations of a cardiac anomaly affect the whole life of a person.

But if the anomaly worries the young patient, constant monitoring is required. Perhaps the cardiologist will recommend certain restrictions and prescribe treatment.

• Encourage your baby to alternate and adhere to a regimen of activity and rest;
• Monitor the diet and quality of food;
• Take your child to physical therapy classes;
• Temper the baby;
• See that the child is often on the street;
• Restrict your children from stressful situations;
• Get enough sleep;
• Do not allow your child or teen to engage in heavy or strength sports;
• Do not give your baby medications without agreeing to take them with your doctor:
• Talk to your primary care cardiologist or pediatrician about extracurricular activities.

Her main disease is hypertrophy, without adequate treatment it can lead to death. What is LVH or hypertrophy? This is a thickening of the walls of the ventricle, a general increase and an increase in the mass of the heart muscle.

A disorder called LVH is shown on a cardiogram. There are certain signs that allow the cardiologist to identify hypertrophy.

The severity and number of signs allow you to make the correct diagnosis, but not always. With hypertrophy of the left stomach, the anatomical cardiogram sometimes does not allow you to see its signs, the cause of incorrect diagnosis may be inadequate interpretation of the cardiogram.

Therefore, the diagnosis can be established taking into account the symptoms and other concomitant diseases.

An increase in the left ventricle and tachycardia may disturb athletes whose heart muscle is under constant stress, in which case an increase in the mass of the ventricle is considered natural, physiological.

The main diseases associated with LVH:

• aortic stenosis;
• aortic insufficiency;
• cardiomyopathy;
• arterial hypertension.

A hypertrophied left ventricle is diagnosed in older people suffering from atherosclerosis of the heart valves.

In order to prevent further development violations, parents should show their children to a cardiologist and undergo all necessary examinations.

Diseases that cause enlargement of the left ventricle:

• chronic kidney problems;
• endocrine disorders;
• aortic stenosis;
• hypertension;
• heart defects;
• avitaminosis;
• oncology.

On the cardiogram, hypertrophy is characterized by an increased amplitude of the QRS waves, especially in the precordial areas.

Diagnostics distinguish several main features that allow LVH to be distinguished:

• Significant deviation to the left side electrical axis. In infants from 4 to 30, in older children over 30.
• Large amplitude of RaVF and RaVL teeth.

• Rv4R-Vj tooth is completely absent or its size is smaller than SV4R.

Q - R interval is expanded in the left part of the precordial zone.

The T wave and ST segment are offset from the QRS complex.

To make a correct diagnosis, the doctor needs to capture the overall picture of changes in the cardiogram, indicating an increase in the left ventricle.

An increase in the left ventricle is rarely diagnosed as a separate disorder, most often it is a symptom of the underlying disease, therefore, after identifying a problem in children, its cause is established. Therapy in this case is aimed at eliminating this disease.

With congenital heart defects that cause left ventricular hypertrophy, surgery is performed, after which the symptoms are relieved with drugs.

The ongoing treatment should slow down the progress of pathological processes. The therapeutic list includes:

• drug therapy;
• diet;
• physiotherapy;
• normalization of the daily routine.

To reduce the severity of symptoms in the child's diet, it is necessary to include foods rich in trace elements, vitamins, and omega fats. Strengthen the myocardium magnesium, calcium, potassium, Q-10.

It is very important to reduce the child's salt intake to a minimum, such products as sausages, fast food, salted cheeses, canned food and ready-made semi-finished products should be banned. Food is recommended to be lightly salted before serving.

Drug therapy includes drugs that help restore cardiac activity and strengthen the heart muscle. Antiarrhythmic drugs are used to normalize the rhythm. medicines.

Violation in healthy people involved in sports is asymptomatic, intense exercise causes the heart to pump large volumes of blood, while gradually developing an increase and thickening of the myocardium, adapting to high stress.

Concentric LVH is characterized by a uniform increase, while cardiomyocytes grow, but the internal structure of the organ does not change.

Runners, active game players, and athletes involved in static sports develop eccentric hypertrophy.

Cyclists, rowers, skaters, wrestlers and weightlifters are most often diagnosed with a mixed form of the disorder.

Athletes with LVH are at risk for developing heart attacks and strokes, so doctors recommend gradually moving away from heavy physical exertion, not changing the lifestyle associated with stress drastically.

Expansion of the cavity of the left ventricle and thickening of its walls is a pathological condition caused by myocardial overstrain.

mild hypertrophy. There is a deviation from the norm of the right ventricle, but it is still insignificant. The letters Q, R, and S denote the characteristics of ventricular contraction.

Now let's see in what cases a cardiologist can make a diagnosis - right ventricular hypertrophy. But it is worth noting that the ECG does not clearly show right ventricular hypertrophy, in contrast to left ventricular hypertrophy. The etiotropic method of treatment is used in case of identified congenital heart disease.

If right ventricular hypertrophy causes heart disease, then the patient will be shown surgical intervention. If right ventricular hypertrophy is recognized at an early stage of development, then this process can not only be stopped, but also reversed. All rights reserved. An increase in the mass of the right ventricle occurs when various diseases respiratory and circulatory systems.

In this case, the pressure in the right and left parts of the heart is equalized. This leads to a decrease in oxygenation (oxygen saturation) of the blood, as well as to hypertrophy. Diagnosis of an increase in the size and mass of the right ventricle is usually made using standard methods cardiological examination.

ECG signs of right ventricular hypertrophy can only be determined by an experienced physician, since this area of ​​\u200b\u200bthe heart contributes much less to the electrical potential than the left ventricle. By changing the teeth, you can only establish the presence of an increase in the ventricle, but the dimensions of the chamber themselves cannot be determined.

Hypertrophy of the left ventricle of the heart is not distinguished as a separate disease, it is considered a sign of many ailments in a child. In most cases, this symptom occurs with heart disease, hypertensive diseases, other serious ailments that are detected by a cardiologist individually, depending on the patient's condition.

The size of the internal space of the left ventricle is calculated from the leaflets of the mitral valve. The distance between the endocardinal surfaces of the intergastric septum (left) and the posterior wall of the ventricle is calculated.

In a healthy child, these parameters vary from 2 to 5 millimeters. They depend on the frequency of contractions of the heart and breathing (they become smaller on inspiration). The baby grows and the dimensions of his left ventricle, too, the size is affected by the surface area and weight of the child.

Now you know what symptoms are typical for left ventricular myocardial hypertrophy in children and what modern medicines and folk remedies most effectively help to reduce the pathogenic effect of this disease on the condition and activity of the child. If you find in your child characteristics hypertrophy of the heart, be sure to seek qualified advice from a pediatric cardiologist!

An older child can already talk about his complaints. He is concerned about pain in the region of the heart, fatigue, lethargy, pallor, shortness of breath with little exertion.

The tactics of treating hypertrophy in children is chosen by a pediatric cardiologist or cardiac surgeon after a thorough additional examination and observation of the child.

In case when slight hypertrophy The LV is diagnosed in the early stages, and the underlying disease is treatable, the complete cure of hypertrophy has every chance of success. However, with severe pathology of the heart (past extensive heart attacks, widespread cardiosclerosis, heart defects), complications may develop.

These patients may develop heart attacks and strokes. Long-term hypertrophy leads to severe CHF, with edema throughout the body up to anasarca, with complete intolerance to normal household stress. Patients with severe CHF cannot move normally around the house due to severe shortness of breath, cannot tie shoelaces, and cook food. In the later stages of CHF, the patient is not able to leave the house.

• pain in the heart and shortness of breath, which are aggravated by physical exertion;
• weakness, dizziness;
• cardiopalmus;
• swelling of legs and feet, especially in the evening.

• acute or chronic cardiac decompensation,
• sudden cardiac arrest
• ventricular fibrillation,
• ischemia or infarction of the heart muscle,
• arterial thromboembolism,
• stroke.

1. Calcium channel blockers - Diltiazem, Verapamil (for heart attack, angina pectoris, arrhythmia), Amlodipine, Nimotop (for hypertension);
2. Beta-blockers - Betaxolol, Sotalol, Bisoprolol, Atenolol and others - reduce myocardial oxygen demand, in particular, during stress and physical exertion, relieve pain during angina attacks;
3. Antihypertensive drugs - Ramipril, Enalapril.

Consequences

A pronounced load on the heart muscle occurs with a long-term negative effect of high blood pressure. Hypertrophy of the walls of the left ventricle is the result of compensatory changes in the heart, when the heart muscle begins to wear out to ensure normal pumping function. The increase and thickening of the myocardium cannot continue indefinitely - as the disease progresses, the risk of acute ischemia and sudden cardiac death increases sharply.

You need to understand what left ventricular hypertrophy is, and what is the danger to life, in order to reduce the risk with the help of a doctor and prevent dangerous complications.

As you can see, the consequences of the disease are very serious and unpredictable. All pathologies associated with the cardiovascular system require close attention, because inaction can someday be fatal.

Signs of left ventricular hypertrophy on ECG should be confirmed ultrasound examination work of the heart. If the ultrasound does not confirm interpretation of the ECG, no need to worry.

Violation can be caused by increased body weight or vice versa asthenia. This condition is not dangerous.

LVH, accompanied by heart failure, edema, shortness of breath, ventricular extrasystole, tachycardia, requires medical intervention.

The consequences of left ventricular hypertrophy can be varied. Thus, an enlarged muscle begins to lose its elasticity over time, this leads to an increase in the pressure of the “motor” itself and the coronary arteries.

The disease is characterized by the following complications: arrhythmia (disturbance of the rhythm), coronary disease, angina pectoris, heart failure (expressed by the inability of the body to pump the required amount of blood), heart attack and sudden cardiac arrest. All this indicates that the consequences can be serious and unpredictable.

It must be understood that many pathologies associated with the cardiovascular system require increased attention. In this case, you cannot do nothing. After all, this can lead to the development of more serious diseases. Of course, deaths are not ruled out.

Dilatation and hypertrophy of the left ventricle usually does not lead to a significant change in the position of the heart in the chest. An exception is cases of severe stenosis of the left venous opening. This phenomenon is characterized by an enlarged left atrium, which pushes the left ventricle, thereby causing the organ to rotate counterclockwise around the longitudinal axis. These cases are extremely rare.

With the disease, there is no change in the position of the central organ around the longitudinal axis. These features are explained by the fact that during dilatation the ventricle encounters resistance in the form of the diaphragm and sternum. Because of this, the pushback increases, which leads to the rotation of the "motor" clockwise.

Hypertrophied left ventricle freely increases upwards, to the left and backwards. Therefore, for a long time, the rotation of the heart is not observed at all. The degree of rotation is determined by the condition of the aortic wall, which in many cases becomes more rigid, preventing the detection of rotation.

Regression of left ventricular hypertrophy is observed approximately 4 weeks after the decrease in blood pressure. This phenomenon is clearly manifested six months after the onset effective treatment Problems.

All this indicates that the disease is not eliminated quickly. It is necessary to undergo a long course of treatment and recovery. Only then will improvement begin to be observed. Moreover, it is constantly necessary to monitor the diet, lifestyle. People with hypertrophy are able to live for decades. But at the same time, you need to take your health very seriously.

Before starting treatment, it is worth consulting with a doctor and undergoing a diagnosis. How to fix the problem, only a specialist can appoint. After all, you can achieve the desired results quickly, but if the state is not properly maintained, regression will occur and everything will have to be repeated.

What types of LV hypertrophy are there?

Depending on the nature of the thickening of the heart muscle, LVH of concentric and eccentric types is distinguished.

The concentric type (symmetrical hypertrophy) is formed when the growth of a thickened muscle occurs without an increase in the cavity of the heart chamber itself. In some cases, the LV cavity may, on the contrary, decrease. Concentric hypertrophy of the left ventricle is most characteristic of hypertension.

Eccentric hypertrophy of the left ventricle (asymmetric) involves not only thickening and increasing the mass of the LV wall, but also the expansion of the cavity. This type is more common in heart defects, cardiomyopathies and myocardial ischemia.

Depending on how thickened the LV wall, moderate and severe hypertrophy is distinguished.

In addition, hypertrophy with obstruction of the LV outflow tract and without it is distinguished. In the first type, hypertrophy also captures the interventricular septum, as a result of which the LV zone closer to the aortic root acquires a pronounced narrowing. In the second type of overlap in the zone of transition of the left ventricle into the aorta is not observed. The second option is more favorable.

Is left ventricular hypertrophy clinically manifested?

If we talk about the symptoms and any specific signs of LVH, then it is necessary to clarify to what extent the thickening of the muscular wall of the heart has reached. So, in the initial stages of LVH, it may not manifest itself in any way, and the main symptoms will be noted from the side of the main heart disease e.g. headache high pressure, chest pain during ischemia, etc.

As the mass of the myocardium increases, other complaints appear. Due to the fact that the thickened sections of the LV heart muscle compress the coronary arteries, and the thickened myocardium requires more oxygen, there are chest pains of the type of angina pectoris (burning, squeezing).

In connection with the gradual decompensation and with a decrease in myocardial reserves, heart failure develops, which is manifested by attacks of shortness of breath, swelling on the face and lower extremities, as well as a decrease in the tolerance of habitual physical activity.

If any of the symptoms described appear, even if they are mild and rarely disturb, you still need to see a doctor to find out the causes of this condition. After all, the earlier LVH is diagnosed, the higher the success of treatment and the lower the risk of complications.

Living with a diagnosis

In order to suspect left ventricular hypertrophy, it is sufficient to perform a standard electrocardiogram. The main criteria for left ventricular hypertrophy on the ECG are violations of repolarization processes (sometimes up to ischemia) in the chest leads oblique or descending ST segment elevation in leads V5, V6, there may be ST segment depression in III and aVF leads, as well as a negative T wave) . In addition, voltage signs are easily determined on the ECG - an increase in the amplitude of the R wave in the left chest leads - I, aVL, V5 and V6.

In the case when the patient has signs of myocardial hypertrophy and LV overload according to the ECG, the doctor prescribes an additional examination. The gold standard is an ultrasound of the heart, or echocardioscopy. On EchoCS, the doctor will see the degree of hypertrophy, the state of the LV cavity, and also identify possible cause LVH. The normal LV wall thickness is less than 10 mm for women and less than 11 mm for men.

Often, changes in the size of the heart can be judged by performing a conventional chest x-ray in two projections. Assessing some parameters (the waist of the heart, the arcs of the heart, etc.), the radiologist may also suspect changes in the configuration of the heart chambers and their sizes.

The level of activity and ability to work of patients depends on the underlying disease, which led to left ventricular hypertrophy. If blood pressure is slightly elevated or corrected by antihypertensive drugs, there are no complications, then there are no grounds for restricting work activity.

In the case of acute disorders of the cerebral, coronary circulation, severe heart failure, working patients with hypertrophy are sent to an expert commission to determine the disability group. A decision can be made on partial or complete disability.

If the deterioration is temporary, there is no permanent loss of vital functions, then the treatment is carried out in a hospital, and the patient is issued a sick leave. After normalization of blood circulation, he can continue to work in his specialty.

Ventriculotomy performed in patients with a single ventricle, due to an erroneous diagnosis, as a rule, leads to the death of patients, therefore, its timely diagnosis and difference from defects that can be successfully operated on under cardiopulmonary bypass are of particular importance. Correct diagnosis determines tactics when choosing one or another method of palliative intervention.

The diagnosis of a single ventricle of the heart can be helped by recording an ECG right or especially a leftogram with simultaneous overload of "both" ventricles in a cyanotic patient, as well as the presence of a high-voltage ECG and type S in chest leads, with the exception of Vi.

According to radiographs, the diagnosis can be assumed in patients with aortic sinistrotransposition, when there is a solid, slightly convex or straight line in the region of the 1st and 2nd arches that are not differentiated, in combination with bulging in the region of the 3rd arch along the left contour of the heart , formed by a graduate for the left aorta.

During cardiac catheterization, significant diagnostic value is the establishment of blood arterialization in the ventricle compared to the right atrium, approximately the same pressure and blood oxygen saturation in the "right" ventricle and systemic artery, especially in patients with cyanosis, as well as the typical position of the catheter during passage it from the "right" ventricle to the aorta, located on the left contour of the heart.

Of decisive importance is selective ventricular angiocardiography in two projections, which allows you to establish an expanded cavity of the single ventricle, which occupies most of the cardiac shadow both in frontal and lateral projections, from which simultaneous or almost simultaneous contrasting of the main vessels occurs, as well as the presence of a graduate, etc. d.

The differential diagnosis should be made with ventricular septal defects and high pulmonary hypertension, with a common atrioventricular canal, with corrected transposition of the main vessels and ventricular septal defect, tetralogy of Fallot, complete transposition of the main vessels, tricuspid atresia.

normal metabolism

In this case, hypertrophy of the right ventricle develops in the child. Average degree of hypertrophy. The pathogenetic method is used for "acquired" hypertrophy of the right ventricle. Daughter 1 year old. Passed an electrocardiogram, in the conclusion the hypertrophy of a right ventricle is written. A slight hypertrophy of the right ventricle on the ECG does not make significant changes.

Mitral stenosis, which is characterized by a decrease in the area of ​​​​the opening that connects the right atrium and the ventricle of the same name. Pathology of the heart, formed in the womb. This causes a decrease in the amount of oxygen carried, as well as an increase in the load on all parts of the heart, including the right ventricle. The case when the mass of the right region is significantly greater than the weight of the left ventricle is an acute hypertrophy.

Is it a hereditary anomaly?

In addition, such a failure in the development of the baby can be affected by poor ecology and excessive stress of the mother during pregnancy. And if the expectant mother also smokes, the percentage for the development of cardiac anomalies in the baby increases even more.

A feature of the development of the child's body is the lag in the growth of the heart from all other organs, this imbalance is especially pronounced towards the end of the puberty period. Therefore, with high physical or emotional stress during this period of time, the stage of decompensation with hypertrophy develops much faster than in adults.

The disease is characterized by fatigue, lethargy, constant headaches and heart pain. All this needs to be paid attention to. It is necessary to monitor the nutrition of the baby, especially if he has a predisposition to being overweight. It should be excluded fried, flour, smoked, use less salt. In some cases, the pathology is not completely eliminated, so you will have to maintain the child's condition constantly. People have been living with this problem for decades.

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In this case, it is possible to establish the fact of hypertrophy and its degree, as well as to identify the most significant deviations in the structure of the heart. Right ventricular hypertrophy on the ECG, unfortunately, becomes noticeable only with pronounced and most often irreversible changes.

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By itself, an extra chord is not a disease. Do not be alarmed if your child has this anomaly. Surgical intervention in this particular case is not provided.

It happens that the pathology of the extra chord in the left ventricle leads to the appearance or development of other heart diseases.

But it is not worth talking about something like this in advance. Periodically see your child with your doctor and monitor his lifestyle.

Left ventricular hypertrophy (cardiomyopathy) is a typical heart lesion for patients diagnosed with hypertension. Left ventricular hypertrophy, the symptoms of which allow us to consider this pathology as a process involving structural adaptation of the heart in relation to metabolic needs relevant to the myocardium, as well as changes occurring in hemodynamic parameters, is quite dangerous in the sense that often the end of the disease is death.

general description

According to statistics, the mortality rate for left ventricular hypertrophy is about 4%. Consider the features of this disease.

Hypertrophy provokes a significant thickening of the wall of the left ventricle, and this thickening does not occur at all due to the peculiarities of the internal space, which is not subject to changes. Quite often, hypertrophy also leads to a modification of the septum located between the right and left ventricles.

Remarkably, left ventricular hypertrophy is often noted among young people, and often in itself it is not even a disease, nor is it a diagnosis, representing only one of possible symptoms any type of heart disease.

As we have already noted, left ventricular hypertrophy can develop due to hypertension. In addition, among the predisposing factors are various options heart defects, frequent and significant loads.

This disease also occurs against the background of stable high blood pressure. Meanwhile, it was found that hypertrophy with its characteristic changes can also occur, as we noted, during physical exertion, which in particular involves the appearance of a state of borderline loading (loaders, athletes, unstable distribution of loads).

The sharp and, at the same time, intense load that the myocardium receives in people whose lifestyle is predominantly sedentary, as well as in people who smoke and drink alcohol daily, becomes dangerous. And if left ventricular hypertrophy does not lead to death, then this does not make it safe for the patient, because it can cause either, which often entails quite serious consequences for the body. The nature of the occurrence of the disease can be congenital (hereditary) or acquired.

Summing up, it can be noted that left ventricular hypertrophy acts as an alarm indicating the complication of the conditions in which the myocardium is currently located. That is, it is in some way a warning that indicates the need to stabilize blood pressure, as well as the correct distribution of the load.

Diagnosis of cardiomyopathy

Scientists can definitely say that there is a family predisposition to left ventricular hypertrophy. Take a good look at the biographies of your grandparents. Perhaps you will find similar patients among them. This will serve as food for thought.

If there are no sick relatives, then there is another theory, rather mysterious, which does not explain anything at all. In some people, under the influence of unknown factors, genes that are directly related to the state of myocardial cells begin to mutate. Under the influence of this mutation, the heart muscle grows.

Anatomy

The main anatomical characteristic of the defect is the three-chamber structure of the heart, which has two atria, which communicate through the mitral and tricuspid openings with the cavity of a single ventricle.

The internal architectonics of the single ventricle, according to the observations of Van Praagh et al. (1964), may have the structure of the left ventricle (in the absence of development of the right ventricle), the right ventricle (in the absence of development of the left ventricle), the left and right ventricles (with agenesis of the interventricular septum) and the infundibular section of the right ventricle (in the absence of development of both ventricles).

The cavity of the single ventricle, as a rule, is enlarged, its wall is hypertrophied. The inner surface of the ventricle is usually homogeneous throughout, trabecularity is pronounced. In rare cases of the absence of a graduate, there is a sharp hypertrophy of the supraventricular crest, which separates the outflow tract from the ventricle. In most cases, the cavity of the single ventricle is crossed by a powerful muscle cord that limits the graduate.

The graduate is a smooth-walled chamber ranging in size from 1.5X1 to 3.5X2.5 cm, from which one or both main vessels depart. The graduate is located on the anterior surface of the heart and is separated from the cavity of the ventricle by a muscular ridge. The latter should probably be considered an malpositioned interventricular septum, based on the fact that this crest contains the conduction system and, in particular, the bundle of His.

The alum is usually considered to be part of the outflow tract of a single ventricle rather than a separate ventricle. This opinion is confirmed by the fact that the blood in the graduate comes from the cavity of the ventricle, and not the atrium. small size the orifice leading to the graduate can reduce the volume of blood flowing through it and thus play the role of subvalvular stenosis.

Most often, the atrioventricular valves do not communicate with the graduate at all, but cases have been described when their structures were attached to the edges of the opening leading to the graduate (Lambert, 1951).

A certain pattern is noted, which is expressed in the fact that with the normal arrangement of the main vessels, the pulmonary artery departs from the graduate (but both vessels can also depart), and when they are transposed, the aorta (or both vessels). With aortic dextrotransposition, the graduate occupies an anterior-right position, and with synistrotransposition (vessels as in corrected transposition) - anterior-left position.

Much less often, the graduate is absent and both vessels depart directly from the cavity of the single ventricle. Embryologically, this is possible, on the one hand, in the absence of development of both ventricles and the interventricular septum (most often there is a two-chamber heart), when the main vessels, regardless of their location, depart from the ventricular chamber, and, on the other hand, with isolated agenesis of the interventricular septum .

The normal location of the aorta and pulmonary artery is observed in 8% of cases, in the remaining 92% transposition of the great vessels is observed.

With a single ventricle of the heart, an anomaly of the origin, distribution and number of coronary arteries is often observed. In patients with a normal arrangement of the main vessels, their normal discharge can be observed. But in half of the cases, an anomaly is noted, which consists in the fact that the posterior aortic sinus can become coronary. In some cases, the right coronary artery may depart from it, in others - the only coronary artery.

With the correct position of the aorta, the right aortic sinus is usually non-coparate. The left coronary artery arises from the left aortic sinus and is located in the left atrioventricular sulcus anterior to the pulmonary artery trunk. With sinistrotransposition of the aorta, unlike the norm, there is an anterior aortic sinus and two posterior aortic sinuses - right and left, and the right coronary artery comes out of the right aortic sinus, and the left coronary artery - from the left one. In such cases, the anterior aortic sinus is non-coronary.

Less often, there is a single coronary sinus, from which one or more coronary arteries depart.
Of the concomitant defects, it should be noted stenosis of the pulmonary artery, which is determined in 64% of patients, interatrial messages - in 40%, anomalies in the location of the heart - in 14% of patients.

Classification

The difference in the anatomical variants of the single ventricle, the variety of congenital heart defects associated with it cause a significant diversity of hemodynamic disorders and, therefore, clinical manifestations vice. All this determines the difficulties in systematizing the defect and explains the variety and difference of the proposed classifications (B. A. Konstantinov et al., 1965; van Praagh e. a., 1964; Ansekni e. a., 1968).

An analysis of existing classifications with an analysis of their shortcomings shows that the most complete classification, reflecting the main anatomical and hemodynamic features of the defect and at the same time suitable for clinical use, can only be the classification that is easy to use, reflects the main types of location of the great vessels and contains the main clinical features. hemodynamic data that contribute to the choice of the method of surgical intervention.

Within each of the 4 types of defect, the possibility of the existence of a single ventricle without a graduate or with a graduate is implied, from which, depending on the position of the main vessels, the pulmonary artery, aorta, or both vessels can depart. This sign, as well as the position internal organs, which in a single ventricle can often be reversed or indefinite, are not included in the classification, since they are of secondary importance and do not affect the clinical and hemodynamic picture of the defect.

Depending on the causative factors and the variant of anatomical changes in the left side of the heart, the following types of pathology are distinguished:

1. Asymptomatic hypertrophy syndrome in the left ventricle, detected only on the ECG;
2. Concentric hypertrophy of the myocardium of the left ventricle;
3. Eccentric hypertrophy of the left ventricle;

With an increase in the cavity;

Without changing the size of the chamber of the left ventricle;

1. Asymmetric thickening of the heart muscle.

The general increase in the size of the heart depends on the expansion of the ventricles and atria. With any option for reducing the lumen of the aorta (stenosis against the background of a defect or with atherosclerosis), the load on the left ventricle increases, the muscle of which must work hard to pump the accumulating blood into the vascular system.

In this situation, an eccentric expansion of the cardiac cavity occurs. Concentric hypertrophy of the left ventricle, which occurs with hypertension, is due to a pronounced systolic load during contraction: the heart muscle thickens due to increased work, and not against the background of expansion of the heart chambers.

The first variant of cardial changes is asymptomatic and typical in athletes and hard working people. With other types of pathology, symptoms and signs will be required.

1. Branch V1: in the negative phase, the P wave, for 0.04 s, corresponds to 3 points.
2. Branch V6: the presence of ST and T wave. When using glycosides, 1 point is added, in the absence of glycoside administration - 3 points.
3. Branches V5 and V6: a frequency of 0.05 s adds 1 point.
4. The width of the QRS complex is greater than or equal to 0.09 s, 1 point is given.
5. EOS deviation to the left by 30 degrees is less than or equal to 2 points.

Voltage criteria on the ECG are decisive in identifying hypertrophy. R and S from 20 mm, the height of the S wave in the branches of V1 and V2 is more than 30 mm, and R in V5-V6 is from 10 mm. For the presence of each feature - an allowance of 1 point. Large deviations from the norm require re-diagnosis, and for each increase, 1 point is added to the total amount. This is an effective diagnostic tool that provides a clear ECG picture of a progressive pathology.

Hemodynamics

At the heart of hemodynamic disorders in a single ventricle is the common ventricular chamber, in which the arterial and venous blood ducts mix. The aorta and pulmonary artery, departing directly from the ventricular cavity or from the graduate, have the same pressure, equal to the system. Consequently, in the absence of pulmonary artery stenosis from birth, there is hypertension in the pulmonary circulation, since blood enters the pulmonary artery under high blood pressure.

The initial low resistance of the pulmonary vessels leads to significant hypervolemia of the pulmonary circulation. In connection with an increase in the MO of the blood of the pulmonary circulation, the volume of blood coming from the left atrium into the ventricle increases. This volume exceeds the volume of venous blood coming from the right atrium.

The prolonged existence of increased pulmonary blood flow leads to a gradual increase in pulmonary vascular resistance, resulting in a decrease in the volume of blood entering the pulmonary circulation. In this regard, oxygenated blood returns to the left atrium in a smaller volume. With a decrease in pulmonary blood flow, the proportion of arterial blood in the cavity of the single ventricle decreases and arterial hypoxemia increases. In such patients, cyanosis appears or it intensifies.

The presence of concomitant pulmonary artery stenosis causes a deficit in pulmonary blood flow. This leads to the fact that arterial blood in a relatively small volume is mixed with venous blood in a large volume in the ventricle. In such patients, as a rule, blood oxygen saturation in the arteries is quite significantly reduced. great circle circulation and there is severe cyanosis.

Clinic

All patients complain of fatigue and shortness of breath with mild physical exertion; 40% of patients are worried about shortness of breath at rest; 30% of patients complain of recurrent stabbing pains in the region of the heart. In patients with increased pulmonary blood flow, frequent respiratory diseases, pneumonia.

An objective examination in 85% of patients reveals cyanosis, which is usually noted immediately after birth, but it can appear at the age of 1-2 years. To a greater extent, cyanosis is expressed in the presence of stenosis of the pulmonary artery in patients. The content of hemoglobin in their blood can reach 20-22 g%, the number of red blood cells - 7,000,000, hematocrit up to 50-60%.

Normal coloration or pallor of the skin and visible mucous membranes can be observed in patients with a sharply increased pulmonary blood flow, but with moderate exercise they usually develop acrocyanosis.

The frequent lag of patients with a single ventricle in physical development (78% of cases) and the presence of signs of circulatory failure (24% of cases) once again indicate the severity of the defect. Half of the patients have a positive symptom of "drum sticks", which is a manifestation of chronic oxygen deficiency. "Heart hump" is determined in 1/3 of patients.

During auscultation over the region of the heart, a systolic murmur is heard, and in patients without pulmonary artery stenosis, it is most pronounced in the third-fourth intercostal space. In patients with pulmonary artery stenosis, the noise is rough and most pronounced on the basis of the heart, according to the level of stenosis.

An independent systolic murmur heard at the apex is usually associated with relative mitral valve insufficiency. The second tone is accentuated and may be associated with pulmonary hypertension, anterior aortic valves in transposition of the great vessels, or with increased blood flow through them in the presence of pulmonary stenosis.

The study of the electrocardiogram with a single ventricle of the heart did not allow most researchers (B. A. Konstantinov et al., 1965; F. G. Uglov et al., 1967; Gasul e. a., 1966) to identify pathognomonic signs. Despite the great diversity of electrocardiographic data, the following patterns can usually be noted - a frequently observed deviation of the electrical axis of the heart to the right (71% of cases) and right ventricular hypertrophy (94% of cases), which in half of the patients is combined with left ventricular hypertrophy.

If a similar picture can be observed in many congenital heart diseases accompanied by pulmonary hypertension and less often with pulmonary stenosis, then the presence of a high-voltage ECG in chest leads, with the exception of Vi, the predominance of S waves over R waves, or equivalent RS complexes may more likely indicate the presence of the only ventricle of the heart (O. G. Shpuga et al., 1970). In addition to this, in patients with aortic sinistrotransposition, but according to Keith et al. (1958), Gasul et al. (1958), Anselmi et al. (1968), Q waves were absent in the left chest leads and were recorded in the right chest leads.

Only deviation of the electrical axis of the heart to the left, observed in 20% of cases, or isolated left ventricular hypertrophy, especially common in a cyanotic patient, can be considered one of the reliable electrocardiographic signs of a single ventricle of the heart, although in these cases differentiation with tricuspid atresia is necessary.

Violations of atrioventricular conduction occur in 17% of cases and are more often observed in patients with aortic sinistrotransposition. Their appearance Shaher (1963) explains the abnormal development and location of the conduction system of the heart in this heart disease.

Content

LVH is a specific lesion of the heart, in which it increases in size and becomes more susceptible to any changes. Hypertrophy affects mainly the myocardium - the strongest muscle of the heart wall, makes it difficult to contract, as a result of which the risk of developing other diseases increases.

What is left ventricular hypertrophy

Cardiac hypertrophy, or, in other words, hypertrophic cardiomyopathy, is a thickening of the wall of the left ventricle of the heart, which leads to malfunction of the aortic valve. The problem is common among patients with hypertension, as well as athletes, people leading a sedentary lifestyle, alcohol addicts and those who have inherited a tendency to pathology.

Hypertension of the myocardium of the left ventricles of the heart belongs to class 9 on the ICD 10 scale, along with other diseases of the circulatory system. This pathology is mainly a syndrome of other heart diseases, the indirect signs of which are manifested. In order to prevent possible problems in the future, it is necessary to intensively treat the hypertrophied organ in a timely manner, immediately after the detection of pathologies.

Degrees of left ventricular hypertrophy

Depending on the signs of LVH and the size of the deformed muscle tissue, several stages of the development of the disease can be distinguished:

Moderate left ventricular hypertrophy (LVH) occurs as a consequence of hypertension or other heart disease. This seemingly insignificant increase indicates an overload of the heart and that the risk of myocardial diseases (heart attack, stroke) for the patient increases. Often proceeds without any signs, is found only in the analysis of the ECG. If the left ventricle is enlarged, it is necessary to be treated with the help of specialists, best of all - permanently.

Severe LVH is characterized by dystrophic changes in which the mitral valve is located close to the surface of the septum and interferes with blood flow, causes excessive muscle tension and stress on the left ventricle.

Enlargement of the left ventricle of the heart - causes

The causes of left ventricular hypertrophy of the heart can be varied, including both chronic and acquired diseases of different parts of the body:

• hypertension;
• obesity: the development of the disease in young children who are overweight is very dangerous;
• ischemia;
• diabetes;
• arrhythmia, atherosclerosis;
• frequent excessive physical activity;
• alcoholism, smoking;
• high blood pressure;
• lung diseases;
• aortic stenosis;
• violations of the mitral valve;
• stress, psychological illness, nervous exhaustion.

The development of the organism in a child can proceed with a violation of the processes of myocardial repolarization and, as a result, an increase in the walls of the ventricle. If such a situation has arisen, it must be prevented, and in the future to be observed stationary throughout growing up and to prevent progression. Constant exercise can naturally lead to heart enlargement, while heavy lifting is a potential threat of systolic overload, so you should normalize your physical activity and monitor your health.

Another indirect cause is sleep disturbance, in which a person stops breathing for a short period of time. It can be observed in women during menopause or in the elderly and entails such consequences as the expansion of the diameter of the vessels of the heart, the growth of the septum and walls of the heart, increased blood pressure, arrhythmia.

Signs of left ventricular hypertrophy

The symptoms of cardiomyopathy are not always obvious, and often people are unaware that there is a problem. If during pregnancy the fetus did not develop correctly, there may be a congenital defect and hypertrophy of the left heart. Such cases must be observed from birth and prevent complications. But if there are periodic interruptions in the work of the heart and a person feels any of these signs, perhaps the walls of the ventricle are not in order. The symptoms of this problem are:

• labored breathing;
• weakness, fatigue;
• chest pain;
• low heart rate;
• swelling of the face in the afternoon;
• disturbed sleep: insomnia or excessive sleepiness;
• headache.

Types of left ventricular hypertrophy

Types of left ventricular hypertrophy differ depending on the structure of changes in the heart muscles. It happens: concentric and eccentric LVH, dilatation of the ventricle. They are distinguished on the basis of echocardiographic indicators (cardiogram) and the thickness of the walls of the organ. Each type of LVH is not an independent disease, but occurs as a result of other pathologies in the human body.

Eccentric hypertrophy

Eccentric myocardial hypertrophy is characterized by an increase in the heart and the volume of its chambers in parallel with the compaction of the muscles of the left ventricle. It is provoked by a sharp growth of cardiomyocytes, their transverse size does not change. Also, eccentric LVH threatens to slow down the pulse, breathing complications. Appears with heart defects or after a heart attack.

Concentric left ventricular myocardial hypertrophy

Concentric HF occurs due to hyperfunction of myocardiocytes due to pressure loading. The size of the cavity does not change, sometimes even becomes smaller. The size of the walls of the left ventricle, the total mass of the myocardium and the heart increase. Concentric hypertrophy occurs with hypertension, arterial hypertension; causes a decrease in coronary reserve.

Dilatation of the left ventricle

Dilatation is an expansion of the left ventricle of the heart, occurs when the work of the myocardium changes or the healthy ventricle is overloaded. If the arc of the heart is elongated, this can also be initial symptom LVH. Sometimes aortic stenosis leads to dilatation, when the narrowed valve cannot perform its pumping function. Past illnesses are often the causes of heart enlargement, in rare cases it can occur on its own, as a congenital pathology.

Why is left ventricular hypertrophy dangerous?

If the left ventricle is hypertrophied, this is not a disease, but it can provoke a lot of them in the future, including the death of heart attacks, strokes, angina pectoris and other heart ailments. Often an increase in the organ occurs due to an active lifestyle, in athletes, when the heart works harder than in the average body. Such changes may not pose a threat, but in each individual case, qualified consultation and advice from a doctor is necessary.

Diagnosis of cardiomyopathy

Diagnosis of left ventricular hypertrophy occurs in several ways: it is the identification of signs of the disease on the ECG, examination of the heart by ultrasound or using a magnetic resonance imaging scanner. If you have any heart problems and symptoms of the disease, you should contact a cardiologist, and if you have already suffered some kind of defect and suspect complications, you need a heart surgeon and, possibly, a treatment system.

Left ventricular hypertrophy on ECG

ECG is a common diagnostic method that helps to find out the thickness of the heart muscle and voltage signs. However, it can be difficult to identify LVH on an ECG without using other methods: an erroneous diagnosis of hypertrophy can be made, since the ECG signs that are characteristic of it can also be observed in a healthy person. Therefore, if they are found in you, this may be due to increased body weight or its special constitution. Then it is worth conducting an echocardiographic examination.

LVH on ultrasound

Ultrasound examination helps to more likely judge individual factors and causes of hypertrophy. The advantage of ultrasound is that this method allows not only to diagnose, but also to determine the features of the course of hypertrophy and the general condition of the heart muscle. Cardiac echocardiography indicators reveal such changes in the left ventricle as:

• ventricular wall thickness;
• the ratio of myocardial mass to body weight;
• coefficient of asymmetry of seals;
• direction and speed of blood flow.

MRI of the heart

Magnetic resonance imaging helps to clearly calculate the area and degree of enlargement of the ventricle, atrium or other compartment of the heart, to understand how strong dystrophic changes are. MRI of the myocardium shows all the anatomical features and configuration of the heart, as if “stratifying” it, which gives the doctor a complete visualization of the organ and detailed information about the state of each department.

How to treat left ventricular hypertrophy

Many people are susceptible to cardiac hypertrophy. If the problem is severe, medical or surgical treatment of left ventricular hypertrophy is performed. At the same time, depending on the degree of damage, treatment can be aimed at preventing the progression of the disease or at returning the myocardium to normal sizes. But it happens that this condition is reversible, if the disease cannot be completely cured, then regression can be achieved by correcting such things as:

• Lifestyle;
• type of food;
• hormonal balance;
• excess weight;
• the amount of physical activity.

Treatment of left ventricular hypertrophy with medication

Medicines for left ventricular hypertrophy of the heart can have an effective result if taken under the supervision of a physician. It is impossible to completely eliminate the symptoms of hypertension, however, taking antihypertensive drugs for this disease and following a diet will help fight the causes and prevent deterioration of health. To cure LVH, the following medications are prescribed:

Verapamil is an angioarrhythmic agent from the group of calcium channel blockers. Reduces myocardial contractility, reduces heart rate. Can be used by both adults and children, doses are set individually.

Beta-blockers - reduce the load of pressure and volume in the heart cavity, help to equalize the rhythm and reduce the risk of a defect.

Sartans effectively reduce the overall load on the heart and remodel the myocardium.

Myocardial hypertension of the left heart belongs to class 9 on the ICD-10 scale, along with other diseases of the circulatory system. Preference should be given exclusively to drugs whose quality has been tested and proven clinically; experimental drugs may not only not have the expected effect, but also adversely affect all health in general.

Cardiomyopathy surgical treatment

Surgery for left ventricular hypertrophy may be needed to remove the hypertrophied muscle in the late and advanced stages of the disease. For this, a transplant of the whole heart or its individual parts is performed. If the cause of LVMH is damage to a valve or septum, transplantation of these specific organs is first attempted, which is simpler than whole heart surgery. In the case of such an intervention, the patient will have to be under the supervision of a cardiologist all his life and take drugs to prevent thrombosis of the coronary vessels.

Alternative treatment of left ventricular hypertrophy

Treatment of hypertrophy of the left ventricle of the heart with folk remedies cannot help in the later stages of lesions, but it can be effective with minor increases, to prevent their development, and reduce the risk of more serious consequences. You will not be able to completely cure the disease, but traditional medicine can alleviate discomfort, chest pain, weakness and fainting. Known means are:

Herbal preparations as an adjunctive therapy for the main treatment (blueberries, motherwort, hawthorn bogulnik, horsetail, cornflower flowers, adonis)

Infused milk: boil and pour into a thermos overnight, or put in the oven until a brown crust forms.

Lily of the valley in the form of drops of tincture or gruel. For tincture, pour lily of the valley with vodka or alcohol, insist in a dark place for 2 weeks, take 10 drops 3 times a day for 2 months. Porridge: pour boiling water over lily of the valley flowers, leave for 10 minutes. Then drain the water, grind the plant and take a tablespoon 2 times a day. Recommended in combination with drops.

Garlic honey: mix crushed garlic with honey in proportions of 1:1, leave for a week in a dark place, take 1 tablespoon 3 times a day before meals.

Dry red wine infused with dried rosemary. Pour the leaves with wine, leave for about a month in a dark place, strain and take before meals.

Cranberries mashed with sugar: 1 teaspoon 4 times a day.

Diet for left ventricular hypertrophy

To adjust the diet for cardiomyopathy, follow these tips:

• give up salt;
• eat often, about 6 times a day, but in small portions;
• quit smoking, drink less alcohol;
• choose foods that are lower in fat and cholesterol;
• limit the amount of animal fats;
• sour-milk, dairy products, fresh vegetables and fruits are useful;
• eat less flour and sweets;
• if you are overweight - follow a diet to lose weight and reduce the load on the heart.

Video: left ventricular myocardial hypertrophy

Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.

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Left ventricular hypertrophy - ECG signs. Treatment of myocardial hypertrophy of the left ventricle of the heart

Left ventricular hypertrophy is a syndrome characteristic of most diseases of the cardiovascular system, which consists in an increase in the muscle mass of the heart.

Unfortunately, today there are more and more cases of left ventricular hypertrophy in young people. The danger of this is complemented by a higher percentage of deaths than in the elderly. Men with left ventricular myocardial hypertrophy die 7 times more often than women.

Development mechanism

In a normal physiological state, the heart, pushing blood into the aorta, performs the function of a pump. From the aorta blood is coming to all organs. When the left ventricle relaxes, it receives a portion of blood from the left atrium. Its quantity is constant and sufficient to ensure the optimal level of gas exchange and other metabolic functions throughout the body.

As a consequence of the formation pathological changes cardiovascular system, it becomes harder for the heart muscle to perform this function. More energy is needed to do the same amount of work. Then the natural compensatory mechanism turns on - an increase in load leads to an increase in the muscle mass of the heart. This can be compared to how, by increasing the load on the muscles in the gym, they get an increase in muscle mass and volume.

Why can't the left ventricle "build up" its muscle mass and not disturb its owner? The fact is that only cardiomyocytes increase in the heart tissue. And they make up only about a quarter of the tissue of the heart. The connective tissue part does not change.

For LV hypertrophy, the capillary network does not have time to develop, therefore, rapidly hypertrophied tissue may suffer from oxygen starvation. Which leads to ischemic changes in the myocardium. In addition, the conduction system of the heart remains the same, which leads to impaired conduction of impulses and various arrhythmias.

The tissue of the left ventricle, in particular, the interventricular septum, is most exposed to hypertrophy.

With intense physical exertion, the heart has to pump more blood, work harder. Therefore, professional athletes may develop moderate left ventricular hypertrophy, which is physiological or compensatory.

Etiology of hypertrophy

In almost all long-term heart diseases, left ventricular hypertrophy is an obligatory consequence.

Hypertrophy of the myocardium of the left ventricle is observed with:

• hypertension;
• aortic valve stenosis;
• hypertrophic cardiomyopathy;
• intense prolonged physical activity;
• obesity;
• smoking, drinking alcohol.

Thus, in any heart disease, left ventricular hypertrophy is a mandatory syndrome.

Hypertension, especially persistent, poorly treated, is the main culprit. If the patient says that high pressure figures are habitual and “working” for him, if hypertension was corrected only occasionally or not treated at all, then he necessarily has a pronounced hypertrophy of the left ventricle of the heart.

Being overweight is a risk factor for hypertension, which results in left ventricular hypertrophy. In addition, in obesity, the blood supply to the enlarged body requires a lot of work to ensure the blood supply to all tissues, which also leads to a change in the myocardium.

Of congenital diseases, the main place is in heart defects with impaired outflow of blood from the ventricle.

However, left ventricular hypertrophy symptoms will show the same for any etiology.

Types of hypertrophy

According to the degree of change in the shape of the left ventricle of the heart and its thickness, eccentric and concentric hypertrophy of the left ventricular myocardium is distinguished.

Concentric hypertrophy of the left ventricle is characterized by thickening of its walls. Its cavity in this case does not change. It is formed when the ventricle is overloaded with blood pressure. This form is typical for hypertension. This etiology is at least 90% and has a high risk of life-threatening cardiovascular complications - more than 35%.

Eccentric left ventricular hypertrophy is characterized by the relative preservation of the thickness of the walls of the ventricle, the increase in its mass and the size of the cavity. The risk of severe complications is about 25%. This species develops with an excess volume of blood.

How to suspect a disease

For a long time, left ventricular hypertrophy of the heart has minor symptoms or the heart does not let you know that it is working through force. When compensatory possibilities are exhausted and a person begins to complain, changes in the myocardium are already significant.

The following signs of left ventricular hypertrophy appear in varying degrees of severity:

• dyspnea;
• tachycardia;
• cardiac pain;
• feeling of weakness and fainting;
• fast fatiguability.

Timely early detection reduces the risk of severe complications. ECG signs of left ventricular hypertrophy are easily determined by any therapist. This method is cheap and informative.

Left ventricular hypertrophy on the ECG is manifested by an increase in the transit time of the impulse, ischemic changes on the ECG, impaired impulse conduction, axis deviation to the hypertrophied region, a shift in the electrical position of the heart, and the location of the transition zone.

Treatment

If there is difficulty in breathing, there is a desire to stop and catch your breath with the usual load, if it presses in the chest, there is an unreasonable weakness, then you should consult a doctor.

The cardiologist will prescribe a complete clinical, biochemical and instrumental examination. On examination, specific heart murmurs and an increase in its boundaries can be detected. An X-ray examination will show how enlarged the heart is, in which departments. An echocardiogram will help determine the localization of disorders, with the degree of decrease in heart activity.

Once the diagnosis of left ventricular myocardial hypertrophy is established, treatment depends on the degree of its severity and the severity of the general condition of the patient.

A change in the size of the heart is a consequence of other diseases. When treating a patient diagnosed with left ventricular hypertrophy, the causes that led to it are of paramount importance.

Depending on the severity of the patient's condition and how severe left ventricular hypertrophy is, treatment can be carried out in a hospital or at home.

A prerequisite for the success of treatment is the right lifestyle. If this recommendation is ignored, any therapy is useless.

Constant monitoring of the ECG and pressure levels, regular examination by a cardiologist is required.

If the condition is satisfactory, regular walks in the fresh air are good. Also, moderate hypertrophy of the left ventricle does not exclude sports walking, swimming in a sparing rhythm. Large physical activities are excluded.

Medicines are taken throughout life. These are calcium channel blockers, beta-blockers, antihypertensive drugs, metabolic cardiac drugs.

Complications

Complications are more than dangerous. This is circulatory failure, and rhythm disturbances, and ischemic changes, and myocardial infarction.

Cardiovascular insufficiency is the inability of the heart to perform its pumping function and provide the body with blood.

Rhythm disturbances occur as a result of the fact that the conduction system of the heart does not have the ability to hypertrophy. The time and quality of the impulses are changed. There may be areas where the impulses do not pass.

Ischemic manifestations (lack of oxygen in the tissue) occur due to the relatively slow development of the capillary network in hypertrophied heart tissue. As a result, she receives less oxygen. On the other hand, when working with an increased load, myocardial oxygen demand increases significantly.

With hypertrophy of the left ventricle of the heart, treatment continues for a long time. It has been proven that early treatment and the responsible attitude of the patient to it can significantly improve the quality and duration of life in patients.

Video about left ventricular hypertrophy:

What is systolic and diastolic pressure

Blood pressure is an indicator that determines the force of blood pressure on the walls of blood vessels. This is one of the most important parameters that determine general state human body. Each heartbeat fluctuates between an upper and lower number. This is called systolic and diastolic pressure - we will talk about what it is in our article.

• Systolic indicator
• Difference between values
• Systolic lower than diastolic
• Prevention

Systolic indicator

Systolic pressure - what is this indicator? This is the top number when determining blood pressure. It represents the strength of blood flow at the time of contraction of the heart muscle. The stronger the heartbeat, the higher this parameter. Large arteries, such as the aorta, are directly involved in its formation. This indicator depends on such factors:

• the volume of the left ventricle;
• maximum heart rate;
• heart rate;
• elasticity of the aortic wall.

It determines not only the heartbeat, but also the speed of blood flow through the vessels.

Diastolic pressure - what is it? This indicator determines the lowest pressure during the weakening of the heart muscle. The diastolic indicator directly depends on such factors:

• patency rate of peripheral arteries;
• heart rate;
• the degree of extensibility of the walls of blood vessels.

The higher it is, the lower the elasticity of the vascular walls.

Difference between values

The norm of the arterial indicator is 120 to 80. This means that the difference between the upper and lower numbers should be 40. If it increases or decreases, then this indicates certain violations in the functioning of the human body. A large difference between the systolic and diastolic indicator can be caused by such irritating factors:

• insufficient elasticity of blood vessels;
• cerebral hypoxia;
• emotional overstrain;
• regular stressful situations;
• myocardial infarction;
• pre-stroke state.

The procedure for measuring blood pressure is required to be carried out 2 or 3 times to obtain the most accurate result - the error of measuring instruments can be quite high.

Systolic lower than diastolic

What does this state mean? If a patient, after measuring blood pressure, has a situation where the diastolic index is higher than the systolic one, this indicates serious violations of the functioning of the internal organs. This pathology is called secondary hypertension. The most common reasons for this deviation may be:

1. Diseases of the kidneys or adrenal glands. The kidney system is responsible for the production of vital hormones. Their excess or lack leads to the development of many diseases. Most often, an increased diastolic figure is observed in people with one kidney.
2. Work disruptions thyroid gland. An increased diastolic figure is one of the symptoms of thyroid diseases. It is observed in the early stages of damage to the body. It is also accompanied not only by physical ailments, but also by mental disorders.
3. Pathological processes in the spinal canals. Accompanied by aching pain in the lower back.
4. Weak excretion of fluid from the body. Especially often observed in women during pregnancy, menstruation or overeating. In order to avoid this pathological process, you need to drink more fluids, limit salt intake, and lead a mobile lifestyle.
5. Atherosclerosis. This disease significantly reduces the elasticity and muscle tone of blood vessels.

You need to carefully monitor your health and respond to any, even minor ailments. It is better to purchase a portable blood pressure monitor at the pharmacy, with which you can measure blood pressure at home. This will help to identify deviations from the norm as quickly as possible and contact a specialist in a timely manner.

Low diastolic pressure with a normal systolic rate does not pose a particular danger to human life. It can be caused by certain medical conditions such as:

• allergic manifestations to certain irritants;
• dysfunction of the vegetative-vascular system;
• toxic poisoning of the body.

Also, reduced diastolic pressure is often observed in women during pregnancy. This condition is not pathological. In order to feel good, a woman during the period of bearing a child should eat right, drink enough fluids and spend as much time as possible in the fresh air.

Prevention

What is dangerous deviation of blood pressure from the norm? It can be caused by many diseases and pathological processes that develop in the body. Therefore, it should be carried out preventive actions in order to keep this indicator normal:

• devote enough time to rest and sleep;
• eat right (mode, diet);
• spend enough time outdoors;
• Minimize the consumption of drinks and foods containing caffeine.
• avoid excessive physical exertion, stressful situations and emotional overstrain;
• monitor the normal condition of the spine.

Also, do not forget that you need to get rid of bad habits. You need to quit smoking and avoid excessive drinking.

Calcium channel blockers: what are they and who are they assigned to?

Calcium channel blockers are prescribed for the treatment of coronary heart disease. Also, these medicines can be prescribed for hypertension and heart rhythm disturbances.

general information

Calcium channels are understood as protein formation. Through this formation, calcium ions move out of the cell to the cell. These particles take an active part in the "birth" and carrying out electrical impulse. In addition, they provide contraction of the muscle fibers of the heart.

1. Angina pectoris.
2. Hypertension.
3. Myocardial infarction.

If a patient is diagnosed with exertional angina, he is prescribed the use of diltiazem or verapamil.

Typically, these drugs are prescribed to young patients suffering not only from angina pectoris, but also from sinus bradycardia.

Also, taking this drug can be prescribed for obliterating atherosclerosis of the vessels of the legs. Sometimes this medicine is recommended for people suffering from cerebovascular insufficiency.

Sometimes the doctor resorts to a combination of calcium channel blockers with verapamil. But this combination should be used with great care. Otherwise, there is a risk of a decrease in myocardial contractility.

Blockers of slow calcium channels are usually prescribed for hypertension. Taking these drugs can provoke the reverse development of left ventricular hypertrophy. These drugs are also taken to protect the kidneys. Their use does not cause metabolic disorders.

Usually, with hypertension, the patient is prescribed amlodipine. This is especially true if hypertension is combined with angina pectoris. The drugs help improve kidney function in diabetic nephropathy. Often, their reception is prescribed for the diagnosis of renal nephropathy.

If hypertension is combined with cerebrovascular insufficiency, the patient is prescribed nimotop. When hypertension is associated with disorders heart rate, the doctor recommends that the patient take diltiazem and medicines of the verapamil groups.

When is it contraindicated?

Calcium channel blockers have categorical and relative contraindications. Relative contraindications include:

• cardiogenic shock;
• dysfunction of the left ventricle;
• atrioventricular block;
• sick sinus syndrome.

Another serious contraindication is a decrease in systolic blood pressure to 90 millimeters of mercury. Art. These medications are not recommended for Wolff-Parkinson-White syndrome.

Categorical contraindications include bright sinus bradycardia and digitalis intoxication. People with chronic constipation should not take these drugs.

You can not combine these drugs with nitrates and beta-blockers. Otherwise, there is a serious risk of a strong decrease in blood pressure.

Side effects

For drugs from the nifediline group side effects due to peripheral vasodilation. Preparations of the verapamil group with prolonged and uncontrolled use affect the heart.

The main side effects include:

• headaches;
• swelling of the lower extremities;
• bradycardia;
• reflex tachycardia;
• decreased urination;
• constipation;
• rashes on the skin.

Headaches are often combined with vague dizziness. Blood often rushes to the face, the skin turns red. At the very beginning of treatment, a sharp decrease in blood pressure can be observed. Usually hot flashes are caused by taking nifediline.

Puffiness is usually observed in the ankles and feet. If they swell upper limbs, then the elbows are affected first.

Against the background of prolonged use of dihydropyridines, a person may experience symptoms of gingival hyperplasia. It is impossible to take these drugs with stenosis of the carotid vessels and aorta. Otherwise, there is a risk of ischemic stroke.

What drugs exist?

According to the classification, these medicines are divided into 3 main groups. In each of them medicines of the first and second generations are allocated. They differ from each other in the purposefulness of the impact and the duration of the effect.

The list of drugs includes:

• a diphenylalkylamine group (this includes drugs such as finoptin, isoptin and anipamil);
• the benzothiazepine group (this includes drugs such as dilacor, tilzem, and altiazem);
• the dihydropyridine group (this includes drugs such as cordipin, corinfar and riodipine).

Medicines from the diphenylalkylamine group affect the blood vessels and the heart. They differ in the presence of hypotensive, antiarrhythmic and antianginal effects. Taking these medicines helps to reduce the heart rate.

Drugs of the dihydropyridine group promote vasodilation. They are rarely exploited in the treatment of arrhythmias. The main purpose of these drugs is to increase the heart rate.

The main difference of this group is that the drugs have a more pronounced effect. In addition, these drugs are well tolerated by patients.

Application effect

The mechanism of action of these drugs is as follows:

1. Regulation of the rhythm of contractions of the heart.
2. Providing a beneficial effect on cerebral blood flow.
3. Reducing mechanical stress in the myocardium.
4. Stopping the appearance of blood clots.
5. Decrease in pulmonary artery pressure.

Given that these drugs help regulate the rhythm of heart contractions, they are often prescribed to a patient with arrhythmias. Given the beneficial effect on cerebral blood flow, drugs can be prescribed to a patient who is under medical supervision after a stroke.

In addition, these drugs have an antispastic effect that increases cardiac circulation. Against the background of regular intake of drugs, there is a decrease in the need of the heart muscle for oxygen. At the same time, the myocardium is supplied with oxygen and other nutrients.

Given that these medicines help to lower the pressure in the arteries of the lungs, they are taken not only as antihypertensive drugs.

Only the attending physician can increase and decrease the dosage. Changing the dosage on your own can lead to unpredictable consequences.