Enlargement of the Left Ventricle

[Tee Smart]

I recently had some test done with the result of having Enlargement of the Left Ventricle as well as a high blood pressure.

What exactly does this mean in Lay terms?

Many Thanks,

Tee.

[Cleveland Clinic, MD]

Enlargement of the heart falls into two categories.  The first is hypertrophy of the heart.  This means a thickening of the heart wall muscle.  It is usually due to long standing high blood pressure but may be due to some rare conditions such as hypertrophic cardiomyopathy.  The second type is dilated enlargement.  This is usually due to a history of blockages in the heart arteries.The diagnosis is made with an echocardiogram and sometimes heart cath.  

Depending on which type of enlargement is present the treatment will vary.  Keeping the blood pressure in control through medications, diet and exercise is very important to prevent further enlargement.

[garyr]

Hypertrophy (enlargement)of the LV can result from high blood pressure (among other causes, like regurgitant or stenotic valves, hypokinesis (a reduced contractility or squeeze); it can also be a normal enlargement such as that of an athlete's heart, with little consequence.

If your LV enlargement (meaning the internal cubic centimeter volume of the chamber is greater than a normal range) is the result of high blood pressure, that means your blood vessels' inelasticity is causing the LV, the main pumping chamber of the heart, to work too hard against the unyielding blood vessels.

While the chamber is expanding in size both internally and externally gradually over time to accommodate the blood that it can't pump out, the muscle of the LV itself is thickening (think of a body builder who is getting progressively 'muscle bound'); it could eventually result in an increasingly progressive inefficiency of the LV to pump sufficient blood out of the lungs to the body, which could then result in congestive heart failure.  

The good news is that it is treatable with ACE inhibitors and other palliative drug treatments. Reductions in this kind of LV enlargement and dysfunction are highly successful.

Any specific questions that I can answer my email is
***@****.

I have both LV Hypertrophy and mild Hypokinesis.

[Lori22]

A related discussion, Left Ventricle enlargement was started.

[Gary]

Excuse me, but I have not had much if any problem with blocked arteries, determinations made by CCF's own cardiololgists. Both my hypertrophy and enlargement are the result of two valvular problems: stenosis and regurgitation as a result of rhuematic fever damaging the mitral and AV.  

Why have you not included faulty valves as a cause of LV enlargement or am I getting the wrong diagnosis?

[Cleveland Clinic, MD]

Gary - yes, valvular abnormalities can also cause hypertrophy.  However, the most common cause is long standing high blood pressure.

Michael - TEE is a well accepted method of determining valvular regurgitation, however, the cause cannot always be determined from echo and that is where the history and supplementary testing comes into play.

[Cleveland Clinic, MD]

Gary - yes, valvular abnormalities can also cause hypertrophy.  However, the most common cause is long standing high blood pressure.

Michael - TEE is a well accepted method of determining valvular regurgitation, however, the cause cannot always be determined from echo and that is where the history and supplementary testing comes into play.

[Mike501]

I would like to know if TEE (transesophageal echo )can be reliably used instead of conventional echo to determine the morphology of valve regurgitation -as Gary mentioned having it due to rheumatic fever .
I have mitral regurgitation since two years and prior to that
I did not have it.Would it be possible to determine the cause
of regurgitation based on its mechanism for instance retraction thickening due to either one causes so that possible risk factors could be eliminated :rheumatic ,lupus rythematosus,carcinoid,ergot lesions,postradiation .

Michael