Hypertrophy of the heart

Hypertrophy is an increase in size and weight of the heart muscle or myocardium. It occurs in response to increased pressure load on the heart. It may be concentric (without dilation) or eccentric (with dilation) hypertrophy of the myocardium, and may involve either or both ventricles. Concentric hypertrophy is caused by increased afterload from hypertension, aortic stenosis and hypertrophic cardiomyopathy. Increased preload, on the other hand, causes eccentric hypertrophy and is seen in mitral and aortic regurgitation, left to right shunts etc. Lumen is smaller than normal in concentric hypertrophy while it is dilated in eccentric hypertrophy.

Features of hypertensive heart disease

• Seen in untreated hypertension of long duration
• Predisposes to IHD
• Concentric LVH
• Eccentric hypertrophy in severe cases
• Arrhythmias (AF, ventricular tachycardia, PVCs)
• Cardiac Failure
• Diastolic dysfunction
• Aortic insufficiency