HOCM or LVH?

[Saylor23]

My cardiologist in Kentucky diagnosed me with LVH with a thickness of 1.5mm. What's the difference between LVH and HOCM at this size? He has no family history of me I only know my mom (no heart probs) I don't know my dad who is black I am mixed. I'm 24 yrs old could this be HOCM and how do you tell the difference? My systolic is high 140ish/ 70-80 (normal systolic)

[Saylor23]

I do cardio, but I'm going to start adding more. What's the odds of sudden death with my condition. Being at 1.5mm in thickness can I still live a normal life span? Also is it likely since I'm 24 that my condition will likely only gradually get worse?  I plan on switch my meds next visit because right now it's around 140/70 with 3 meds.

[is_something_wrong]

I agree - it's confusing. While every increase in left ventricular wall thickness technically is LVH (hypertrophy basically means enlarged muscle- you could also say biceps hypertrophy after some weightlifting), the term LVH is usually reserved for hypertrophy for a reason. It could be from exercise (in which case it's known as physiological hypertrophy) or it could be from some cardiovascular disease, where the most common is high blood pressure but there are also others, like some valve conditions. They are in your case ruled out (all heart valves leak a little - if they didn't they wouldn't function, as they passively close when blood starts to run back).

HCM (Hypertrophic cardiomyopathy) is a specific type of LVH (the word cardiomyopathy is a bit misleading because there doesn't have to be cardiomyopathy as in heart failure involved) where the heart walls grow in the absence of any cause (or grow abnormally much in response to for example exercise). I'm not sure why it happens but I think it's genetic. Sometimes the septum grows so much that it starts to block outflow from the heart, if it does it's known as HOCM.

[Saylor23]

I'm currently on meds, I remember vaguely what he told me about the thickness I remember my Ejection fraction being 55-60% area...my thickness was 1.5mm not sure if it was septum or wall I'm thinking the wall. He also said all else was normal besides the LVH to take the meds, watch overdoing salt, and he clearly seen I exercised so that's all he said. I think I had a small leaky valve but said it was minor.

[Saylor23]

First off thanks so much for the response and information it was very informative. I didn't know that HOCM was obstructive the ventricular where LVH was just thickening..thanks for that.

I'm

[is_something_wrong]

First, the O in HOCM means obstructive. In other words, the septum is so thick that blood flow from the left ventricle is obstructed, which is a dangerous condition, but it can be seen on echo. If your doctor didn't mention it, you probably don't have it. It usually happens with septum thickness >2 cm.

I guess your question is whether you have LVH from weight lifting (normal), high blood pressure (not normal but common) or if you have the genetic disease HCM (thickened left ventricle walls in the absence of an obvious cause). A systolic blood pressure of 140ish (close to normal) usually doesn't cause LVH, but it can't be ruled out. Maybe it's the combination of lifting and slightly high blood pressure?

In the setting of HCM, the septum is usually thicker than the posterior wall. With LVH they tend to grow fairly similar. How thick is the PW? Genetic testing can reveal HCM, but your doctor must determine if that's necessary.

In the meantime, it wouldn't harm you to lower your blood pressure to closer to 120 than 140. If it's OK for you to exercise, maybe you should focus on cardio exercise rather than just lifting?

[Nicole8712]

I would get the second opinion of another cardiologist.I would also call your cardiologist and ask all those questions. Write them down beforeheand if you have to. One of the key features of HCM is LVH.

[Saylor23]

I also lift weights and he told me I was ok to do so?