Left ventricular hypertrophy is defined as an increase in the
mass of the left ventricle, which can be secondary to an
increase in wall thickness, an increase in cavity size, or both
Risk factors for left ventricular hypertrophy include the
High blood pressure, a blood pressure reading greater than
140/90 mm Hg, is the greatest risk factor.
Aortic stenosis, narrowing of the main valve through which
blood leaves the heart, may increase the left ventricle's
Obesity can cause high blood pressure and increase your
body's demand for oxygen, factors that may lead to left
The development of LVH is a relatively early response to
Ambulatory BP monitoring has suggested that there may be two additional
risk factors for LVH:
The daily BP load (the percentage of pressures above 135/85 during the day
and 120/80 mmHg at night
Nocturnal hypertension (in which the expected nighttime reduction in BP is
maximal daytime blood pressure or peak exercise blood
pressure are most predictive of the level of hypertrophy .
There is also evidence that left ventricular mass may be
increased prior to the development of overt hypertension.
High BP → ↑ LV wall stress
Wall stress ∝ 1/ wall thickness
LV wall thickening → ↓ wall stress
Myocyte hypertrophy and ↑ collagen matrix
.The same factors, such as angiotensin II, norepinephrine,
epinephrine, increased peripheral and cardiac sympathetic
drive and endothelin, promote both hypertension and LVH.
The tendency to LVH may be an inherited trait that
predisposes to the development of hypertension
› To diagnose LVH you can use the following criteria*:
R in V5 (or V6) + S in V1 (or V2) > 35 mm, or
R > 13 mm
Shortness of breath
Rapid exhaustion with physical activity
Some time patient shows no symptoms
systolic murmur best heard between the apex and
left sternal border
- increases in intensity with maneuvers that
decrease preload (Valsalva, squatting to
- does not radiate to the carotid arteries
sustained apical impulse
bisferiens pulse (carotids, femoral arteries)
Complications that can occur as a result of these problems
Inability of your heart to pump enough blood to your body
Abnormal heart rhythm (arrhythmia)
Insufficient supply of oxygen to the heart (ischemic heart
Interruption of blood supply to the heart (heart attack)
Sudden, unexpected loss of heart function, breathing and
consciousness (sudden cardiac arrest)
right ventricular hypertrophy is the enlargement of heart’s
Right ventricular hypertrophy, or simply RVH, is considered to
be one of the rare diseases of the heart. Unlike the left
ventricle, which tends to overwork itself when it detects
abnormalities, the right ventricle dilutes itself. This is the
reason why left ventricular hypertrophy is way more common
than right ventricular hypertrophy.
Hyperkalemia: affects Na channels and causes
Na channels inactivate and refractory.
Ventricular fibrillation and asystole.
At the same time increases activity of potassium
channels and increases memb. repolarization.
Blood transfusion, Massive hemolysis
congenital adrenal hyperplasia
Burns,necrosis,tumor lysis syndrome
Potassium containg dietary supplements
Hyperkalemia:causes hyperpolarization of RMP.
Greater than normal stimulus is required to generate A.P.
Opposite in case of heart and it become hyperexcitable. Lower A.P in
atria may cause arrhythmias.
Renal artery stenosis
Tumors of adrenal gland
required for Na/K ATPase. Normal Mg inhibits
release of K . In hypo more K is released so cells depolarize
rarely too high to effect heart but may cause heart to fail to
relax during diastole and eventually stops in systole(Ca rigor).
Post renal transplant
exact mech. nt known but ECG changes are seen.