Mr. Zhang, who was less than 60 years old, always felt uncomfortable in his chest a while ago. He went to the hospital for an examination, which showed that his heart showed signs of hypertrophy. This time, Mr. Zhang was frightened. He was afraid that he would have a myocardial infarction. After all, his father died of a heart attack. After consulting the doctor, the doctor believed that his heart hypertrophy might be caused by the failure to improve long-term high blood pressure. He prescribed a more suitable antihypertensive drug and reassured Mr. Zhang that his problem was not serious, but Mr. Zhang is still a little puzzled, why is the heart hypertrophic?

Physical examination revealed cardiac hypertrophy, but no obvious symptoms, why is this so?

Electrocardiogram, chest X-ray and heart ultrasound are the most common tests that people do when they go for a physical examination, especially the middle-aged and elderly people who pay attention to cardiovascular diseases, and will do related tests. Some people feel that they do not have symptoms such as palpitations and shortness of breath, but they have undergone a health examination and found that they have a problem of cardiac hypertrophy. At this time, the patient needs to go to a cardiovascular specialist for further confirmation.

Cardiac hypertrophy has almost no symptoms in the early stage. When the symptoms of palpitations and shortness of breath appear, it means that the heart has begun to be unable to bear the burden. In severe cases, breathing difficulties, chest pain, dizziness, fatigue, ischemia, heart failure, and arrhythmia may even occur. sudden death. However, when these serious symptoms appear, the disease is often advanced to an advanced stage, so it does not mean that the presence of cardiac hypertrophy is necessarily very dangerous.

What causes heart hypertrophy?

Cardiac hypertrophy is generally divided into two categories:

1. Morbidity: Many diseases can cause cardiac hypertrophy, including heart valve disease, high blood pressure, chronic kidney disease or dialysis, age, and familial genetics. Cardiac hypertrophy may be caused by mutations in cardiac protein-related genes, most of which are dominantly inherited, and 50% of the mutated genes will be passed on to the next generation. It has been known that a variety of gene defects can cause hypertrophic cardiomyopathy, and specific gene defects are still high. sudden death rate. Therefore, patients with genetic inheritance should be highly regarded.

2. Physiological: Long-term and strenuous exercise by professional athletes increases myocardial contractility. Athletes’ muscles are thicker than ordinary people, and the same is true for the heart. They should undergo regular cardiac function tests. In a state of continuous high-intensity exercise, the ventricular wall will thicken and the heart will become physiologically hypertrophic. The general public does not need to deliberately challenge their physical limits when exercising. The extreme marathon is not suitable for everyone, and the intensity is too high for most people. Normal exercise is a good thing for people, but if the amount of exercise exceeds the limit of the human body, it may be a burden. News of sudden death in marathon running is often heard, so especially patients with chronic diseases should do physical exercise before exercising. Evaluation is necessary.

What are the methods for diagnosing cardiac hypertrophy?

The heart has a certain normal range. Generally, the thickness of the heart is less than 1cm, and the standard for determining cardiac hypertrophy is greater than or equal to 1.5cm.

Through image examination such as electrocardiogram and chest X-ray, although it cannot be 100%, it can quickly screen out some patients with cardiac hypertrophy, but there is no way to quantify the thickness of the heart. Through cardiac ultrasound, magnetic resonance imaging (MRI), and cardiac computed tomography (CT), the severity of cardiac hypertrophy can be seen from the images. Because cardiac hypertrophy is genetically inherited, these patients may also need genetic testing and family screening.

Some familial hereditary patients have no signs in the process of growing up. They may have clinical symptoms at the age of 30 or 40, and the diagnosis will be made only after the images are abnormal. Most patients are usually silent, and most are discovered accidentally during physical examination. For genetically inherited cardiac hypertrophy, a family history can help identify the source of the mutation and identify other family members who may be at risk.

Most hypertrophic cardiomyopathy lesions are dominantly inherited, with a 50% chance of being passed on to the next generation. Identifying the causative gene can help family members to be diagnosed before symptoms appear, preferably close relatives (parents, siblings, and children) have electrocardiograms and echocardiograms. If a family member has a definite disease-causing gene mutation, the relatives of the parents should undergo genetic testing, and family members with the same mutation should be evaluated to determine whether it is a genetic or mutational factor.

When family members develop heart disease symptoms in old age, genetic testing can be used to identify whether it is congenital cardiac hypertrophy or other pathological cardiac hypertrophy caused by hypertension. Genetic diagnosis can be regarded as a differential diagnosis tool.

For cardiac hypertrophy caused by other factors, a disease process is required, such as high blood pressure, which generally takes more than ten years. However, this is in the case of no intervention in high blood pressure. If blood pressure can be controlled through diet, work and rest, and drugs, Then there may not be a problem of cardiac hypertrophy, so chronic diseases should be treated and improved as soon as possible.

What are the dangers of cardiac hypertrophy?

People with hypertrophic hearts have a higher mortality rate than the general population and are at risk for heart failure, arrhythmias, stroke and sudden death.

Physicians determine the most appropriate treatment plan based on the underlying cause of cardiac hypertrophy. Patients with mild disease can be controlled by drug treatment; patients with severe myocardial hypertrophy have a risk of sudden death greater than 6% within five years. At this time, placement of an intracardiac defibrillator (ICD) in some patients can effectively prevent sudden death. After surgery, although symptoms are relieved, regular follow-up examinations are still required to prevent danger.

Can the heart shrink after hypertrophy? What are the methods of treatment?

The way to prevent or slow heart hypertrophy is to treat high blood pressure, heart valve disease, chronic kidney disease, follow the doctor’s order with appropriate medication, and for some patients, it can even be reversed back to normal. The best prevention lies in daily healthy life and rest, actively controlling blood pressure, living a regular life, quitting smoking, quitting alcohol, controlling weight, and regularly tracking and checking health status.

Professional athletes have heart hypertrophy due to training. When training is stopped and the exercise intensity is reduced, the heart will gradually return to its original size.

Genetically inherited cardiac hypertrophy is more difficult to control, and some treatments may slow down or stop the progression. Early detection and early treatment are the key points. The risk to the next generation of patients with familial inheritance is greatly increased. It is best to let the child be screened early, and it is best if it can be treated early before symptoms occur.

Some patients said that their parents did not have heart-related diseases, but each person felt different symptoms. It was also possible that their parents had cardiac hypertrophy without complications, which was a potential case ; It may be a single gene mutation, and the prognosis of follow-up treatment is very good. 80% of the patients can follow-up examination and take medicine.

The most worrying thing about cardiac hypertrophy is the possibility of sudden death, reminding the public that if the family has a history of cardiac hypertrophy, they should seek medical examination.