How is Left Ventricular Hypertrophy Treated?
How is Left Ventricular Hypertrophy Treated?
Treatment of left ventricular hypertrophy (LVH) is to treat the cause. Treatment can be medical or surgical depending on the cause and patient’s condition.
Treatment of left ventricular hypertrophy includes the treatment of the causes. Hypertension is treated with life style modifications and drugs. Aortic valve stenosis should be surgically treated. Hypertrophic cardiomyopathy can be treated with drugs, surgically of with implanted devices. Athletic hypertrophy does not need any treatment.
If Hypertension is Causing Left Ventricular Hypertrophy
If hypertension is causing LVH or left ventricular hypertrophy then the treatment approaches adopted are.
- Changes in Life Style
- Losing Weight– LVH is a condition seen more in individuals who are overweight or obese irrespective of blood pressure. Losing weight has shown to reverse the LVH. This can also help control your blood pressure.
- Healthy Diet – eat more fruits and vegetables, reduce refined carbohydrates, food with saturated fats
- Limit Salt in your Diet - reduce the amount of salt intake, and do not eat food which contains high amount of salt (dried fish, sprats)
- Regular Exercise – at least 30 minutes for 3 to 4 days per week. Try brisk walking for 30 minutes every day. If you have any other heart conditions or if you become breathless while doing exercises consult your doctor.
- Smoking cessation
- Stop consumption of alcohol, if not drink in moderate amounts
- Manage Stress – meditation
- Thiazide- Diuretics. Diuretics containing thiazide promotes blood flow and decreases high blood pressure. Examples of this class of medications are chlorthalidone (Thalitone) and hydrochlorothiazide (Microzide). These can be used as monotherapy or combined with other antihypertensive drugs. This is the first choice of antihypertensive. But you can always start with any other drug listed below.
- Angiotensin-converting Enzyme (ACE) Inhibitors. These medications make the blood vessels wide thus lowering the blood pressure. When the blood pressure is under normal range there is less pressure on the heart to pump blood. Some of the examples of this class of medications are enalapril (Vasotec), captopril, and lisinopril. Dry cough is one of the common side effect associated with these medications.
- Angiotensin-II Receptor Blockers (ARBs). This has the similar effect as ACE inhibitors, but it does not cause the persistent cough. Example is Losartan (Cozaar). Usually ACEI and ARB’s are not combined and given as it can increase the potassium level.
- Calcium Channel Blockers. These medications prohibit calcium from infiltrating the cells of heart and walls of blood vessels leading to a fall in blood pressures. Examples of these classes of medications are. Amlodipine (Norvasc) and diltiazem (Cardizem, Tiazac).
- Beta Blockers. Medications such as atenolol (Tenormin), acebutolol (Sectral) can lower your heart rate, reduce blood pressure and prevent some adverse effects of hormones which cause stress. This type of medications is not the preferred route chosen by physicians to treat hypertension. The physician might add a beta blocker if the current medication that the patient is on is not effective in lowering the blood pressure.
Treatment for Aortic Valve Stenosis, Which Causes Left Ventricular Hypertrophy
In aortic valve stenosis, the opening of the aorta becomes small; therefore, the left ventricle has to push the blood harder, this increase the workload on the heart. This will require a surgical procedure to make the valve wide or in some cases where the valve is completely damaged replace it with an artificial one.
Hypertrophic Cardiomyopathy Treatment
- Left ventricular hypertrophy or LVH as a result of hypertrophic cardiomyopathy can be successfully treated with medications, surgery, implanted devices and certain lifestyle changes.
- Life style changes are same as hypertension. However you should ask your doctor if you can exercise or not and what sort of exercise you should do and how long.
- Medications to relax your heart muscle and slow the heart rate.
- Beta blockers – metoprolol, propranolol and atenolol
- Calcium channel blockers – verapamil, diltiazem
- If you have any arrhythmias
- Amiodarone or other anti-arrhythmic drugs
- Blood thinners to prevent blood clots – warfarin
- To remove part of the thickened septum between the ventricles
Implantable cardioverter-defibrillator (ICD)
These are usually inserted if you get a life threatening arrhythmia or at risk of getting a sudden cardiac death. ICD is a small device that continuously monitors your heartbeat. If you get a life threatening arrhythmia then this machine will automatically release electrical shocks to resume the normal heart rhythm.
Athletic Hypertrophy Causing Left Ventricular Hypertrophy
Left ventricular hypertrophy caused because of athletic hypertrophy does not need any treatment, but it is better that you stop exercising for about 3 to 6 months. During this time, an ECG and 2D echo can be repeated to see the thickness of your left ventricle.