Hypertrophy of the heart

The heart ensures that blood is pumped through the body and consists of heart muscle cells. Hypertrophy of the heart means that the individual heart muscle cells grow, but their number remains unchanged. This can be caused by various diseases of the heart, the most important being valvular defects, high blood pressure, heart failure and hypertrophic cardiomyopathy (HCM).

Heart valve defects can occur on any heart valve, the most frequently affected are the aortic and mitral valves in the left part of the heart, since this is part of the body’s circulation and is subject to greater stress than the right part of the heart due to the significantly higher blood pressure than in the pulmonary circulation. In the case of stenosis, the affected valve cannot open properly, which puts even higher pressure on the heart. The heart reacts by growing inwards (concentric hypertrophy).

In an insufficiency, the affected valve cannot close properly, causing the heart to be burdened by excess blood volume, it reacts with outward growth (eccentric hypertrophy).In case of high blood pressure, the heart has to work against a greater resistance than usual. In heart failure or weakness, the heart is no longer able to pump enough blood through the body to supply all organs. The body therefore tries to improve the pumping capacity of the heart by means of hypertrophy.

This method works well for some time, but if the critical weight of 500g is exceeded, the heart itself can no longer be supplied with sufficient blood and the performance of the heart decreases again. Hypertrophic cardiomyopathy is the most common hereditary heart disease, but it can also occur with no apparent cause. About 200 out of 100,000 people are affected.

The heart muscle thickens mainly in the left ventricle in the area of the cardiac septum, which can disrupt the flow of blood into the body’s circulation. The disease is then called hypertrophic obstructive cardiomyopathy (HOCM). For a long time patients have no symptoms, especially the non-obstructive form is often discovered only by chance and is one of the most common causes of sudden cardiac death in young athletes.

Possible symptoms are shortness of breath, a feeling of tightness in the chest and cardiac arrhythmia. In milder forms, this condition can be treated with medication (beta-blockers or calcium channel blockers). In more severe cases, the only solution is a procedure in the cardiac catheterization laboratory in which the thickened cardiac septum is removed by cutting off the blood supply.