Hypertrophy of the myocardium

Hypertrophy of the myocardium is a long process of compensatory adaptive myocardial response. The increase in the heart muscle is due to the performance of increased myocardial work without a certain load increase on its muscle mass unit, with available valvular heart defects and hypertension in the BCC or ICC.

This pathological process is physiological and pathological. In the first case, the increase in the heart muscle occurs as a result of increased physical performance or intensive training in any sport. With such hypertrophy, the mass of the myocardium of the whole heart increases with simultaneous increase in muscle mass, which intensively participates in the work of the heart.

Hypertrophy of the myocardium of a pathological nature is formed independently of the processes of the musculature of the skeleton simultaneously with the intensification of the compensatory work of the heart as a result of disorders in the circulatory system. But, nevertheless, it is practically impossible to define a clear boundary between these two types of myocardial hypertrophy. So, for example, in pathological form, the increase in the heart muscle is uneven and is associated with the heart department, which must work hard.

In addition, there are three stages of myocardial hypertrophy, such as emergency, completed( persistent hyperfunction) and the stage of slow exhaustion with progressive cardiosclerosis.

For the emergency stage, development is characterized by increased stress in combination with pathological myocardial abnormalities( glycogen disappears, creatine phosphate decreases, potassium content decreases and sodium content increases, lactate accumulates) as a result of mobilization of myocardial and whole body stores. It is at this stage that the load on muscle mass increases, the structures begin to function quickly and the heart mass increases in connection with protein synthesis and thickening of the fibers.

In the second stage, all the processes of hypertrophy have already been completed, and the mass of the heart muscle increases by almost 100%, IFS( the intensity of the functioning of the structures) is normalized. Pathologies in the structure and metabolism of the heart muscle do not reveal. In addition, hemodynamic disorders are normalized, and the altered heart is already adapted to new loads, and then for a long time takes part in their compensation.

The third stage of depletion is characterized by profound metabolic and structural changes occurring in the cells of the heart muscle. A certain number of muscle fibers die and a replacement for connective tissue occurs, and the IPS begins to grow. At the same time there are violations of the regulatory apparatus of the heart. Progression of depletion processes causes the development of CHF.

Hypertrophy of the myocardial cause of

Under such a change of the heart muscle is meant a pathologically enlarged heart. This anomaly is considered a dangerous condition and does not refer to an independent form of the disease. The formation of myocardial hypertrophy is affected by various cardiac pathologies, which can lead to a worse prognosis of the underlying disease. As a rule, in medical practice, an increase in the left ventricle of the heart is observed, but sometimes there is also hypertrophy of the myocardium of the prostate, and also both.

As a result of this disease, 4% of patients die of sudden death, and 80% of deaths occur with the presence of heart disease.

Hypertrophy of the myocardium is formed as a result of sufficiently increased loads on the heart, which occur against a background of various diseases, high physical activity and nutritional factors.

But arterial hypertension, coronary artery disease, pulmonary heart, excess physical activity and excess weight form the basis of all causes in the development of the pathological process. In addition, factors such as alcohol abuse, smoking, unusual loads in lifestyle with low mobility and changes at the genetic level can trigger an increase in the heart muscle.

This pathological condition can also be characterized by a congenital etiology as a result of myocardial thickening. This occurs as a result of an increase in the volume of muscle fibers.

Hypertrophy of the myocardium can also cause circulatory disorders within the heart itself. This is due to the congenital pathology of the anatomical structure of the heart or it can appear during life as a result of hypertension.

In addition, the increase in cardiac muscle refers to the occupational disease of athletes with pathology mainly LV.This disease manifests itself depending on the reasons that contributed to its formation with a present violation of the rhythm of the heart.

Hypertrophy of the left ventricular myocardium

Today it is the main predictor of early diseases of S.S.S.and death. This pathological process of the heart is also called a silent killer.

The development of LV myocardial hypertrophy is due to the presence of genetic, demographic, clinical and biochemical factors. The demographic factors and lifestyle that are associated with the formation of this pathology include the amount of alcohol consumed, obesity, physical activity, sex, race, age and sensitivity to salt. In addition, myocardial hypertrophy of the left ventricle often affects the male half, and the number of patients with this diagnosis increases with age.

Hypertrophy of the myocardium of the LV is twice as common among patients with high arterial hypertension than with its mild form. However, not only increasing the degree of BP plays a major role in the formation of this pathology, but also the morning pressure rises, both in patients who received treatment with hypertension and who did not receive therapy.

The development of this disease is facilitated by various factors of hemodynamic nature, namely, the violation of the rheological composition of the blood, the altered structure of the arteries, the load on the heart with volume and pressure.

Biochemical factors include: increased activity of the sympathoadrenal system and( RAAS) of the renin-angiotensin-aldosterone system. The higher the angiotensin in the body, the more often hypertrophy of the left ventricular myocardium develops. It is the RAAS of tissues that takes part directly in the formation of such pathological processes as hypertrophy, atherosclerosis and fibrosis.

Among the genetic factors of development of a pathological anomaly, polymorphism of a gene such as ACE, which is a regulatory gene, is distinguished.

Hypertrophy of the myocardium of the LV is of two types: apical and symmetrical, which, as a rule, depends on the place where the heart tissue increases.

Symptomatic at the outset is characterized by an asymptomatic course, so many patients may not be aware of the developing hypertrophy of the myocardium of the LV.

The main complaints of patients include heart pain, increased blood pressure, migraine, dizziness, general malaise, there is an arrhythmia that goes on to angina later.

The first sign of this disease is the appearance of dyspnoea with the subsequent development of fainting conditions or without them. Visually, no special changes are observed, but with a pronounced form of the pathological process, cyanosis of the skin is noted.

To diagnose myocardial hypertrophy of the LV, ultrasound of the heart is used, which is considered the main diagnostic method, by which it is possible to determine the available increase in the heart muscle. The second method of examination is the ECG.In this disease the tooth T changes, and the Q's teeth become pathological, reveal multiple extrasystoles with possible ventricular tachycardia. An alternative to the electrocardiogram is daily monitoring. Additional diagnostics include radiography. When listening, systolic murmur is determined, and at palpation - trembling behind the chest.

At the heart of therapeutic measures of myocardial hypertrophy of the LV is the conduct of drug and symptomatic treatment. In this case, beta-blockers, ACE inhibitors, drugs that normalize heart rate and reduce blood pressure are prescribed. Severe forms of pathological disease require a surgical procedure in order to effect a resection of the enlarged and altered portion of the myocardium. Also important is the observance of the regime of the day and nutrition, of course, a uniform distribution of physical exertion with possible restriction.

Hypertrophy of the myocardium symptoms

This condition refers to the compensatory measure of the body, which is designed to provide blood supply to all of its tissues. Against the background of aortic defects or insufficient functioning of the mitral valve, the increase in the heart muscle develops much more often. However, it is problematic to define this symptomatically, since the signs of the main pathology show themselves.

The process of increasing the heart muscle goes through three stages of development: compensation, subcompensation and decompensation. Clinically, the first two stages do not manifest themselves practically, although at the stage of subcompensation, there are sometimes signs of angina pectoris.

The stage of decompensation is characterized by symptoms indicative of CHF.In this case, patients are disturbed by difficulty breathing, emerging angina, frequent heartbeat, weakness in the muscles, drowsiness and a constant sense of rapid fatigue. Specific signs of this stage of the disease are the swelling of the face, which appears by the end of the day, dry cough and falling pulse tension. In addition, very often symptoms of asthma of the cardiac type are noted, that is, stagnation occurs in the ICC.And this causes shortness of breath, which forces the patient to assume the position of orthopnea. At the same time, swelling of the lower extremities and abdominal cavity is observed, which indicates the manifestation of PZHN.

Since all the symptoms of myocardial hypertrophy appear in the period of decompensation, then in the presence of cardiac defects, there is the possibility of a rapid recognition of the development of this pathology in the initial stages. In addition, if a patient begins to notice a decrease in the functional reserve of SS, that is, he has shortness of breath after performing work or darkens in the eyes, then this is considered an occasion for an urgent appeal to a specialist.

Hypertrophy of the myocardium treatment

The main goal of treatment of this pathological disease is to reduce the increased cardiac volumes to normal values. Basically for this use different methods of treatment of myocardial hypertrophy: non-drug;Treatment with the use of medicines and surgical intervention.

The first variant of therapy consists in refusal of the patient from nicotine and alcohol;Elimination of significant physical loads;Reduction of excess weight. Most often, all the therapy is used in the complex. First of all, start with the treatment of the main pathology and prescribe beta-blockers, Verapamil, which are used to treat the existing hypertrophy, but also during the latent course of the pathology. But in those moments when methods of drug treatment are ineffective, a surgical operation is prescribed to solve this problem.

The essence of surgical intervention in myocardial hypertrophy consists of performing two types of operations. In the first case, ischemia is eliminated, which is performed at the last stage of the pathological process( decompensation).This is achieved with the help of angioplasty and stenting of the coronary arteries.

The second type of surgical intervention is the correction of heart defects. To do this, prosthetic valves are performed in case of insufficient function and commissurotomy.

Hypertrophy of the myocardium is a dangerous pathology and with its presence increases the percentage of development of various complications. Therefore, it is necessary to always monitor BP, undergo an annual ultrasound examination of the heart and be observed by a cardiologist to monitor the situation in dynamics.

Thus, in the implementation of all recommendations the outcome of myocardial hypertrophy is favorable and is not a sentence for the patient.