Cardiac muscle hypertrophy is a condition that exists in both humans and animals and is colloquially known as athlete’s heart.
What is cardiac muscle hypertrophy?
Cardiac muscle hypertrophy refers to an abnormality of the heart that affects its anatomy and how it functions. In medical circles, myocardial hypertrophy refers to a so-called compensatory enlargement of the heart muscle. This refers primarily to the ventricular myocardium. In cardiac myocardial hypertrophy, the heart muscle increases in mass and circumference. In practice, a distinction is made between myocardial atrophy in the form of an eccentric or a concentric increase in cardiac muscle, which has different causes. Cardiac muscle hypertrophy affects the entire cardiovascular system. Moreover, both healthy and sick people suffer from cardiac muscle hypertrophy. In itself, cardiac muscle hypertrophy belongs to the non-pathological volume increases of the heart under certain conditions.
Causes
The causes of myocardial hypertrophy are complex. However, they can be understood as a response of the organism to an increased workload due to increased physical stress. This results from the heart’s compulsion to compensate for, to balance, the increased power demand of the cardiovascular system. One of the most important causes leading to cardiac hypertrophy is competitive sports. So-called pressure hypertonia, which results from an increasing load on the ventricles caused, for example, by excessively high blood pressure, also contributes to the development of cardiac muscle hypertrophy. Pressure hypertension may be present in the right ventricle and may be due to pulmonary disease or pulmonary valve stenosis. In addition, left ventricular pressure hypertension (increased pressure in the blood vessels) is also one of the causes of myocardial hypertrophy. This, in turn, is based on stenosis of the aortic valves or excessive blood pressure in the arteries.
Symptoms, complaints, and signs
Myocardial hypertrophy is first noticeable by shortness of breath and cardiovascular symptoms that develop over a period of several weeks, months, or even years. Angina pectoris is also a typical symptom. Chest tightness manifests itself as discomfort behind the breastbone, often associated with a dull, throbbing pain, burning and pressure. It is often accompanied by shortness of breath and dizziness. The pain may radiate to the shoulders, neck, back, stomach and jaw. As cardiac hypertrophy progresses, cardiac arrhythmias and eventually heart failure set in. Many patients complain of signs of heart failure, i.e., gasping for breath, difficulty breathing, and reduced exercise capacity. In general, the risk of heart attack is increased. Myocardial hypertrophy is primarily manifested by cardiac symptoms that occur gradually and are usually chronic. If treatment is given early, the symptoms subside after a few weeks to months. If the disease is not treated, it can be fatal. Prior to this, a thickening of the heart muscle develops, which eventually leads to a heart attack. As a result of the rather negative general prognosis, many affected individuals develop anxiety, depressive moods, and other emotional distress that further affect quality of life and well-being.
Diagnosis and course
Untreated myocardial hypertrophy can lead to complications, which are manifested by an increased risk of infarction or loss of heart function. In order to prevent these risks in time, various diagnostic procedures are important, which are based in particular on advanced medical-technical equipment. In addition, the specialist also has the opportunity to precisely detect cardiac hypertrophy through visual examination of the patient, listening to the heart and lungs, palpation, and laboratory-based tests. In order to be able to clearly show this reaction of the heart to a permanent strain as cardiac muscle hypertrophy, an ultrasound-guided examination of the heart can be considered as a further diagnostic measure. There is also the technical possibility of diagnosing cardiac muscle hypertrophy by means of magnetic resonance imaging.Basically, the onset of pathological myocardial hypertrophy is always insidious, so that symptoms are noticed only gradually.
Complications
First and foremost, cardiac hypertrophy results in severe thickening of the heart muscle. This can result in the development of various cardiac conditions that, in the worst case, can lead to the death of the patient. In most cases, this leads to heart failure, which can be life-threatening if left untreated. The risk of a heart attack is also increased by the cardiac hypertrophy, and so-called gasping for breath usually occurs. The heart is weakened and the patient usually has low exercise capacity as a result. Those affected often feel ill and unwell and no longer take an active part in life. Furthermore, it is not uncommon for the symptoms to cause depression and other psychological disorders, which can have a negative impact on the quality of life of the affected person. As a rule, cardiac hypertrophy is treated with the help of medication. No complications occur, but it cannot be directly predicted whether the treatment will lead to a positive course of the disease. The patient’s life expectancy is usually limited by cardiac muscle hypertrophy and will be reduced to several more years without treatment.
When should you see a doctor?
When symptoms of heart failure are noticed, a doctor should be consulted. Cardiac hypertrophy is manifested by shortness of breath, heart pain, angina and dizziness. If these signs occur and do not subside on their own after a few days at the latest, medical advice is required. This is especially true if other symptoms occur, such as shortness of breath or panic attacks. Non-specific symptoms should also be clarified if they occur over several days or weeks and cannot be attributed to any other cause. People who already suffer from heart disease are particularly at risk. People who lead an unhealthy lifestyle and consequently suffer from obesity also frequently suffer from cardiac hypertrophy. So do competitive athletes and people with chronic lung disease or pulmonary valve stenosis. Anyone who belongs to these risk groups should consult a specialist with the symptoms mentioned. The general practitioner can make the initial diagnosis and refer the patient to an appropriate cardiologist. In case of severe symptoms, the emergency medical service can be contacted first.
Treatment and therapy
Nowadays, the treatment of cardiac hypertrophy can be quite specific. In this regard, the therapy of cardiac muscle hypertrophy is based on several pillars. However, the central piece of the treatment of cardiac muscle hypertrophy is the prescription of drugs. The effect of the drugs contained is aimed at reducing increased physical stress, for example through competitive sports. Sports in which maximum cardiac stress occurs rapidly should also be avoided initially. However, well-dosed physical exercise is permitted. Conventional therapies involve the administration of drugs known as beta-blockers or calcium antagonists, which reduce the output of the left ventricle. If disturbances of the heart rhythm are already present, which can lead to life-threatening ventricular fibrillation, treatment of the myocardial hypertrophy with antiarrhythmic drugs is useful. To support the contractility of the entire heart muscle, digitalis or catecholamines are also taken in the therapy of cardiac hypertrophy. Conventional treatment is augmented by interventional procedures.
Outlook and prognosis
Myocardial hypertrophy is basically treatable and curable. With good medical care, early therapy, and patient cooperation, the enlargement of the myocardium can be altered and reduced. Therefore, in principle, a favorable prognosis is possible. Medical treatment and monitoring of the health condition are necessary to prevent premature death of the affected person. Without medical intervention, the mortality risk is significantly increased. If no other diseases or disturbances of the heart rhythm are present, the patient may achieve freedom from symptoms within a few months. The circumference of the heart muscle is gradually reduced in a controlled manner. At the same time, the patient’s symptoms decrease.Often, lifestyle changes must be made immensely for recovery. Since myocardial hypertrophy mostly occurs in athletes, inner resistance to necessary restrictions in the chosen lifestyle can develop. Competitive athletes are often forced by cardiac muscle hypertrophy to give up their sporting activities almost completely. There is a risk of secondary diseases, since the necessary restructuring causes a strong psychological stress within the transition period. If the affected person does not accept the warnings and the developed therapy plan of the physician, permanent damage to the organ as well as severe respiratory impairments may result. The prognosis in these cases is considered unfavorable.
Prevention
Preventive measures against myocardial hypertrophy include monitoring blood pressure. Excessive blood pressure should definitely be treated. Participation in competitive sports should also include regular medical checkups to rule out health impairments caused by cardiac muscle hypertrophy in a timely manner. As preventive measures in the case of a genetic predisposition to cardiac muscle hypertrophy, surgical interventions are suitable if there is a corresponding family history, which includes the implantation of a defibrillator. This device is also known as a pacemaker and can prevent dangerous ventricular fibrillation in cases of myocardial hypertrophy. A healthy lifestyle is also a useful way to help prevent cardiac muscle hypertrophy.
Prevention
There are usually very few, if any, measures of direct follow-up available to the affected person for cardiac muscle hypertrophy. In this case, the first priority in this disease is to see a doctor as soon as possible to avoid further complications. In the worst case, the affected person will die from this disease if it is not treated properly. In most cases, cardiac hypertrophy is treated by taking medication. The affected person should always pay attention to a correct application and also to the correct dosage of the medication. If there is any uncertainty or if there are any questions, a doctor should always be contacted first. As a rule, physical exertion should be avoided in the case of myocardial hypertrophy, so as not to strain the heart unnecessarily. The doctor can also explain to the affected person which activities are permitted. Furthermore, regular examinations by a physician are necessary to monitor and control the heart. In severe cases, surgical intervention may also be necessary to relieve the symptoms of cardiac hypertrophy. After such a procedure, the affected person must rest and refrain from physical or stressful activities.
Here’s what you can do yourself
In case of diagnosed myocardial hypertrophy, in addition to drug therapy, adjustment of behavior in everyday life and self-help measures are suitable to interrupt the process of hypertrophy of the heart muscle and improve the subjective sensation. It is important to arrange one’s life in such a way that there is no longer any incentive for the heart muscle to react compensatorily with mass increase through demanded performance. This does not mean avoiding all cardiac stress, but sports that involve light endurance stress such as Nordic walking on the flat, swimming and cycling are helpful. Most ball sports have an unfavorable effect because they are associated with previously incalculable power peaks. In addition to light to moderate sporting activities, it is useful to support the process of stress management with recognized relaxation techniques such as Tai Chi, targeted breathing exercises, yoga, Qi Gong or similar techniques. The practice of relaxation techniques, in conjunction with light to moderate endurance sports, results in lower blood pressure and a stable heart rhythm. The heart is thus given an opportunity to regenerate. If the cardiac hypertrophy was caused by competitive sports (athlete’s heart), there is even a chance that it will regress.