left ventricular hypertrophy

I am a 56 year old female, 268 lbs. Three weeks ago I had 2 days of really irregular heartbeats (first time that has happened).  I went to the ER and stayed 24 hours.  I was on a heart monitor, given low dose of lopressor, lots of blood work, and 2 EKGs.  I was told the next day NOTHING WAS REALLY FOUND TO BE WRONG and was sent home with no meds but told to go see my doctor soon for a follow-up.  I did and she said my EKG showed left ventricular hypertrophy.  She put me on 25mg metoprolol twice a day and told me to come back in 6 weeks.  The irregular heartbeats stopped immediately as far as I can tell.  For the past year, when I take my blood pressure at home, I average 135/78.  When I go see the doctor, she gets 160/90 (the nurse gets 140/85).  Thought it was just being nervous at the office. Evidently, I have developed hypertension since I now have LVH.  I have a panic disorder (for 36 years) and I am so frightened about the LVH.  Please give me some words of encouragement. I am 100 lbs. overweight but I have taken eating properly very seriously now and I am losing weight.  If I lose weight and control my blood pressure, is it possible to live a long life?  Can LVH get better with time?  I figure my doctor didn't see the immediate need to get an echocardiagram to determine further damage.  Maybe that is a good sign.  I just need some good news somehow so I can settle down with my nerves and thoughts that I could suddenly die.  Thanks so much for any help.  Annie22  

[Michael J. McWilliams, M.D.]

Believe it or not, LVH is not something that commonly causes sudden cardiac death.  Hypertrophic cardiomyopathy can be dangerous, but LVH is not the same thing.  HCM implies there are myocardial changes that predispose to arrhythmia.

If I lose weight and control my blood pressure, is it possible to live a long life?  

It is important to lose weight and control your blood pressure.

EKGs are good for suggesting LVH but do not confirm LVH unless there are very specific findings.  LVH is often over called on EKGs.  Echocardiograms


Can LVH get better with time?

It can improve with proper blood pressure control if blood pressure is the cause -- it is equally important to stop the progression.  Try to focus on what you can control -- weight and blood pressure with medication and lifestyle.

I hope this helps.  Thanks for posting.

[tickertock]

The only way to truly confirm LVH is to have an echocardiogram, EKGs are notorious for given a false positive for LVH, sometime it is accurate , majority of the time it is a false positive, that being said with a history of HTN and being overweight , it is possible that the EKG could be accurate , but the echo is the gold standard for confirmation. i have been diagnosed with mild lvh myself by echo, only one ekg ever showed borderline voltage for lvh, all my other ekgs are normal, with good bp control and weight control, lvh under these circumstance has a very good prognosis.

[Annette22]

Thanks so much for the encouraging words about EKGs and LVH.  I should go ahead and ask for an echocardiogram.  Hopefully, it shows mild LVH.  All previous EKGs were normal (a few months ago).  Good to hear from you that with good BP and weight control, prognosis can be a good thing.
I'm hoping for good things.  God bless.  Annette22  

[Annette22]

Thank you so very much for your comments.  This forum is excellent.  Your encouragement and positive suggestions have "made my day".  I will continue to lose weight and control BP as best as I can.  Your comments were most helpful.  Have a great day Doctor!  Annette22