Risk Factors for Heart Disease Your Doctor Rarely Mentions

 Part One: LVH

 We can all recite the common culprits for heart disease. Major risks include smoking, diabetes, high blood pressure, high cholesterol, strong family history, previous heart problems, inactivity, and getting older. But beware! Your doctor may not consider a few under-the-radar risk factors for heart disease that are an important part of thorough care.

Left Ventricular Hypertrophy (LVH) is a thickening of the heart muscle. Unlike your biceps muscle, which is stronger and works better when larger, the heart becomes less efficient when its muscle gets too pumped up.

Major causes for heart muscle thickening include: 

• High blood pressure – increases the force against which the heart must pump blood into the rest of the body
• Diseases of the Aortic or Mitral heart valves
• Blocked arteries that feed the heart (coronary artery disease)
• Genetic tendency to heart thickening

What’s more, heart damage is not limited to muscle thickening. The heart becomes scarred as well, leading to permanent damage and heart failure (fluid in the lungs).

 How do you detect thickening of heart muscle? An Electrocardiogram (EKG) can give clues to LVH but is not accurate enough. The most accurate, simple and safe test is an echocardiogram (ultrasound of heart). Your doctor should order a “left ventricular mass index” to get the best look at heart muscle thickness, not the standard “wall thickness.” A cardiac MRI can take even better pictures of the heart but is far less practical to perform.

Some key points to understand about Left Ventricular Hypertrophy (LVH): 

• LVH is itself a risk factor for heart disease
• Heart muscle thickening  can be reversed if treated early and with proper medications such as “ARB’s” or ACE inhibitors or calcium channel blockers
• LVH and heart scarring is not just from high blood pressure: other factors like genetic tendencies, heart valve disease or clogged heart arteries contribute.
• Doctors often do not actively address LVH as a heart disease risk factor. Patients must seek out full heart evaluation if they have high blood pressure, heart disease or other risk factors such as diabetes, high cholesterol or smoking.
• LVH is reversible but can lead to permanent heart damage if left untreated