enlarged heart

[Michelle]

I just found out my father, who is 47 years old, has an enlarged heart. He has a history of high blood pressure and is taking medication for this. What are the risks of having an enlarged heart and does high blood pressure affect or cause this? What are things that he can do to stay healthy with this condition?

[Cleveland Clinic, MD]

Doctors look for changes on the ECG that can indicate someone has a blockage in their artery.  If the cath shows normal arteries than the ECG is presumed wrong.

[Wanda]

ABNORMAL ECG
I HAD A HEART CATH. DONE AND ALL WAS CLEAR.  SHOULD I
WORRY ABOUT MY EKG RESULTS?

SINUS TACHYCARDIA
LEFT ARTIAL ENLARGEMENT
INCOMPLETE RIGHT BUNDLE BRANCH BLOCK
NONSPECIFIC T WAVE ABNORMALITY

AFTER THE DR. READ THIS HE PUT ME IN CCU RIGHT AWAY.
AFTER HEART CATH. HE SAID THAT MUST BE NORMAL FOR ME. I
WENT FROM LOOKING LIKE I WAS HAVING A HEART ATTACH TO
FINE.

WHAT DO YOU THINK?

[Cleveland Clinic, MD]

Dear Michelle,

Thank you for your question.  Left ventricular hypertrophy (LVH) is an enlargement of the left pumping chamber of the heart and may be due to several different things.  The most common cause is high blood pressure.   Other causes are due to exercise (athletic hypertrophy) and congenital (hypertrophic cardiomyopathy or HOCM).  

The diagnosis of LVH is usually made by echocardiogram.  The walls of the ventricle can be measured and a thickness of greater than 1.5 cm is considered enlarged.  Athletic hypertrophy is usually less than this thickness and will return to normal size with cessation of the activity.  HOCM may be diagnosed in the absence of other causes of LVH and with the presence of a family history.

The treatment of LVH depends on the cause.  Hypertensive LVH is treated by controlling the blood pressure.  Some antihypertensive drugs may cause LVH to regress but this is controversial.  Athletic hypertrophy does not require treatment.  HOCM is a rare condition that should be followed by a cardiologist with expertise in this area.  It may require medical or surgical management.

Long term prognosis of LVH is good.  There is an increased propensity to heart failure (see previous questions on heart failure) so a correct diagnosis and proper treatment is essential to decrease this risk.  Hope this helps.