Left ventricular hypertrophy (LVH) is when the heart’s main pumping chamber, the left ventricle, becomes thicker and less able to pump blood efficiently. It usually develops because of another heart condition and treating that condition may stop progression or reverse LVH.

Left ventricular hypertrophy (LVH) doesn’t usually cause symptoms at first, but when symptoms do occur, they often mirror those in conditions such as heart failure. A physical exam and cardiac imaging are usually enough to diagnose LVH.

To manage the condition and improve your heart health, it’s imperative to work closely with your cardiologist and maintain a lifestyle that promotes optimal blood pressure and cardiovascular well-being.

The left ventricle pumps blood out of the heart through the aorta to the body. The right ventricle pumps blood to the lungs, picking up oxygen before returning to the heart to be pumped out from the left ventricle.

When a condition causes the heart to work harder to supply the body with oxygenated blood, the left ventricle walls can become thicker — similar to how other muscles can become bigger from lifting weights or other exercises. This extra work results in LVH.

Less commonly, LVH results from the space within the left ventricle expanding due to an abnormal increase in blood volume traveling through the heart.

Having LVH can lead to life threatening complications, including heart failure and stroke, if it’s not treated effectively.

LVH can be present for a long time before any symptoms become obvious. But when symptoms are present, they can include:

A 2022 study suggests that the primary causes of LVH are high blood pressure and aortic valve stenosis, a condition in which the valve leading from the left ventricle to the aorta becomes stiff and can no longer open sufficiently to let the proper amount of blood enter the blood vessel.

Because the valve won’t open properly, the heart muscle has to work harder to pump enough blood to meet the demands of the body. This results in the thickening of the left ventricle.

Similarly, because high blood pressure (hypertension) means the heart is working harder to pump blood throughout the body, the left ventricle’s walls can grow thicker and larger.

Thickening of the left ventricle can also occur in genetic conditions like hypertrophic cardiomyopathy and conditions that cause protein deposits, like cardiac amyloidosis.

Other conditions that can result in LVH include:

The following imaging tools may be used to help diagnose LVH:

However, a 2017 report suggests that echocardiography is the most accurate imaging technique and is significantly more sensitive than electrocardiography in detecting LVH.

In addition to imaging, a proper diagnosis of LVH should include a physical exam and a review of your medical history and that of your family.

The most effective treatment of LVH is treating the condition that is causing the problem. For example, if high blood pressure has caused a thickening of the left ventricle, taking blood pressure-lowering drugs (antihypertensives) and making certain lifestyle changes may be sufficient.

For aortic valve stenosis or other valve problems, the procedure to repair or replace the affected valve may help reduce the risk of further complications.

Regardless of the cause of LVH and the treatment recommended by your doctor, everyone with the condition should manage the following heart-healthy behaviors:

LVH can sometimes be reversed when the underlying condition is treated effectively. For others, changes to the left ventricle may be permanent. But a healthy, active life may be possible with lifelong care by a cardiologist and adherence to a heart-healthy lifestyle.

Like many other cardiovascular conditions, LVH’s primary risk factor is advancing age. But other risk factors include:

  • having overweight or obesity
  • diabetes
  • family history of LVH or other heart problems
  • having poorly controlled high blood pressure

How common is left ventricular hypertrophy?

LVH affects between 15% and 20% of the general population. It is most often diagnosed in people who have obesity, are older, or have hypertension.

Is left ventricular hypertrophy hereditary?

LVH is usually caused by a heart condition such as high blood pressure or aortic stenosis, which can develop in anyone. However, two genetic conditions can lead to a thickening of the left ventricle: hypertrophic cardiomyopathy and familial amyloidosis.

What are the main complications of left ventricular hypertrophy?

If not managed properly, LVH can lead to heart failure, heart attack, and stroke. A 2021 study published in Frontiers in Cardiovascular Medicine involving more than 130,000 heart patients also suggests that LVH is a strong predictor of arrhythmias and atrial fibrillation.

A diagnosis of LVH means your heart is working extra hard to supply blood throughout the body. Over time, this can weaken the heart, leading to heart failure or other complications. But you can lower your risk of LVH-related complications and further damage to your heart by following the recommendations of your cardiologist and maintaining behaviors that support heart health.