Recognize and treat thickening of the heart muscle | NDR.de – Guide

Status: 10/24/2019 10:44 am

An increase in heart muscle mass, also known as heart muscle hypertrophy, puts a lot of pressure on the heart. To prevent heart failure, the cause must be treated urgently.

More muscle is generally considered desirable, but in the human heart this is a dangerous development. The adult human heart normally weighs about 300 grams, and the muscle that separates the two chambers of the heart is eleven millimeters thick. An increase in heart muscle mass, called heart muscle hypertrophy, usually indicates that the heart is working too hard. At the same time, physical performance is limited.

An exception is endurance athletes. In them, an enlarged heart leads to better performance.

High blood pressure is often the cause of thickening of the heart muscle.

Several factors can cause the muscle mass in the wall of the left ventricle to increase. The most common trigger is high blood pressure. The increased pressure in the arteries makes it harder for the heart to pump open the aortic valve and push blood out to the body. The heart tries to compensate for this increased effort by growing the muscles.

A possible cause is also a narrowed transition to the main artery (aorta) from birth or after a heart infection. Because if the heart valve is too narrow (aortic valve stenosis) or if the flow is obstructed, blood cannot flow easily from the left ventricle to the rest of the body. The wall of the ventricle responds to increased back pressure and increased effort with muscle growth.

The right ventricle is only affected in a few cases, for example in the case of pulmonary vascular hypertension. Hypertrophic cardiomyopathy is a special case: here the heart muscle is thickened due to an inherited predisposition. The disease tends to run in families.

Symptoms of heart muscle hypertrophy appear gradually

Pathological thickening of the heart wall is noted sooner or later in most people due to reduced physical performance. The ventricle can no longer absorb enough blood, and over time its wall not only thickens, but also hardens. Because non-muscle fiber tissue is also stored between muscle fibers. The reduced elasticity of the muscle leads to reduced pumping ability, which often manifests as shortness of breath.

Other symptoms that may indicate a thickened heart muscle:

  • dizziness
  • fainting
  • chronic fatigue
  • thick legs (edema)
  • frequent urination
  • cardiac arrhythmia

Complaints in advanced stages

In the further course, symptoms occur not only under stress, but also at rest. From a weight of around 500 grams, the coronary arteries can no longer supply enough oxygen to the heart. This mismatch between the heart muscle’s oxygen demand and oxygen supply often manifests itself in chest pain, known as angina pectoris. Now, at the latest, there is an increased risk of heart attack and stroke.

Hypertrophy often shows up on ultrasound

Heart muscle hypertrophy can usually be detected by ultrasound of the heart. If this so-called echocardiography does not provide enough information, the doctor may also order a magnetic resonance imaging (MRI) of the heart.

In addition, laboratory values ​​from a blood sample provide information about possible causes of the disease. If high blood pressure is suspected as a trigger, those affected should have a 24-hour blood pressure measurement. Overnight screening tests can be used to determine if sleep apnea caused the thickening of the heart muscle.

Prevent heart failure with timely treatment

A thickening of the heart wall cannot be reversed, with the exception of the athlete’s heart. However, if caught early, the progression of the disease can be stopped with the help of proper therapy. If no action is taken, there is a high probability that develop heart failure (weakness of the heart), which can lead to a heart attack or even death.

Therapy depends on the individual trigger of the thickening. If there is a heart valve defect, this defect is usually corrected by surgery. If high blood pressure is the cause of the thickening of the heart muscle, high blood pressure medication will likely be prescribed. Regular endurance sports can permanently lower blood pressure. On the other hand, peak loads should be avoided. Swimming, running, or walking for at least 30 minutes four to five times a week is adequate.

Donating blood also has an antihypertensive effect in many people. That’s why it can make sense to donate blood three or four times a year.

Lower blood pressure with specific nutrition

Targeted nutrition helps control high blood pressure. Those affected should drink at least two liters a day and make sure not to consume more than three grams of salt a day. Also taboo: prepared foods, wheat and sweets. Instead, high-protein vegetarian dishes with anti-inflammatory spices belong on the menu. Also, intermittent fasting can have positive effects if you are overweight.

More information

Schematic representation of thickened heart muscle © NDR

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