Myocardium

Left Ventricular Hypertrophy

search

Left Ventricular Hypertrophy

  • See Also
  • Pathophysiology
  1. Primary Hypertrophy
    1. See Hypertrophic Cardiomyopathy
  2. Secondary Hypertrophy (See Causes below)
    1. Target organ response
      1. Chronic pressure overload
      2. Chronic volume overload
    2. Angiotensin II directly increases myocardial mass
  • Associated Conditions (LVH associated increased risk)
  1. Coronary Artery Disease
  2. Congestive Heart Failure
    1. Decreased left ventricular systolic function
  3. Cerebrovascular Accident
  4. All cause mortality
  • Signs
  1. Accentuated Apical Thrust on palpation at PMI
  1. Goals
    1. Preserve sinus rhythm
    2. Suppress Tachycardia
    3. Decrease elevated left atrial and diastolic pressures
    4. Avoid excessive Preload reduction
    5. Avoid depressing Cardiac Output
    6. Treat comorbid Myocardial Ischemia
  2. Antihypertensive management
    1. Beta adrenergic blockers
    2. ACE Inhibitors
    3. Angiotensin Receptor Blockers (ARBs)
    4. Low dose Diuretics
    5. Long acting Calcium Channel Blockers
    6. Long Acting Nitrates
  1. See Congestive Heart Failure (Systolic Dysfunction)
  2. Decrease Fluid Overload
    1. ACE Inhibitors
    2. Beta adrenergic blockers
    3. Diuretics
  3. Reduce symptoms
    1. Digoxin
  • Prevention
  1. Control Hypertension