Hypertrophy of the left atrium

Strictly speaking, cardiac hypertrophy is not a disease, it is a very disturbing sign, which can indicate the development of various cardiovascular diseases. The increase in the cells of the heart tissue most often affects the left side of the heart. And, probably, many faced personally or heard from friends about a diagnosed condition such as hypertrophy of the left atrium. What is it? How dangerous is everything, because it is known that from the lungs, the blood enriched with oxygen comes immediately to the left atrium?

What steps should be taken if, when passing a banal ECG, a similar diagnosis should be encountered?

[1], [2], [3], [4], [5], [6],

Causes of left atrial hypertrophy

In general, the causes of left atrial hypertrophy are quite diverse. Among them may be heredity, and extremely overweight, and high blood pressure.

It is sad, but heart problems have long ceased to be the prerogative of the older generation. The age of patients in cardiology departments is rapidly decreasing, and one of the most common causes of this pathology is obesity - and it is in young people and even children.

The hypertrophies of the left atrium and hypertension are susceptible: high blood pressure, naturally, leads to an increase in the load on the heart in conditions of disturbance of normal blood flow.

It causes hypertrophy of the left atrium and a narrowing of the opening that regulates the blood flow between the left atrium and the ventricle (the scientific name for this phenomenon is stenosis of the mitral valve), as a result of which the load on the atrium increases, as normal blood flow is disturbed, and excess blood is retained in the atria. That's why hypertrophy of the left atrium occurs. However, the aortic valve stenosis, which is responsible for the circulation of blood from the left ventricle into the aorta, can cause an increase in this part of the heart. The blood goes out of the heart less and the load on the heart muscle increases, and there are problems with the left atrium.

In addition to the aforementioned mitral and aortic stenoses, mitral or aortic valves may also lead to left atrial hypertrophy. In this case, we are not talking about narrowing one of them, but about their malfunctioning, when the corresponding valve is not able to close tightly. As a result, the blood flows out in the opposite direction, and if we talk, say, about the mitral valve, there is inflammation of the left atrium, which leads to its hypertrophy.

Hypertrophic changes in the cardiac muscle are also caused by myocarditis, when the contractile function of the heart suffers as a result of inflammation, and kidney diseases that cause an increase in pressure. The appearance of hypertrophy of the left atrium is also associated with various infectious diseases of the respiratory tract, which complicate the functioning of the lungs and, as a consequence, the operation of the left atrium.

If you look for the causes of hypertrophy of the left atrium in heredity, then, first of all, you can call hypertrophic cardiomyopathy. In this disease, overload in the work of the heart occurs due to a pathological thickening of the ventricles. The lower chambers of the heart have to work in a strengthened mode to ensure the flow of blood to all organs and parts of the body, which in turn leads to an increase in the heart muscle.

And, of course, a rare heart disease or pathology is not associated with stress. The constant nervous tension can not but affect the level of blood pressure, and hence - the direct path to hypertrophy of the left atrium.

[7], [8], [9], [10]

Symptoms of left atrial hypertrophy

Symptoms of left atrial hypertrophy are not always apparent. If the process of increasing the cardiac muscle does not go too far, then a person can live for a long time without experiencing special health problems and without even suspecting that he has hypertrophy of the left atrium.

Problems begin when the heart tissues are seriously affected. Then even the most everyday activities can darken because of unexpected and unpleasant manifestations of this pathology. For example, during a morning run, swimming, biking, fitness, you may suddenly experience symptoms of hypertrophy of the left atrium, like chest pain or sudden heartbeat. Many, before usual, things start to be given more difficult because of increased fatigue.

Also, with hypertrophy of the left atrium often there are difficulties with breathing. Moreover, with such a pathology, it is recommended to avoid overstrain, since there is a high probability of dyspnea.

Depending on what causes left atrial hypertrophy, the general symptoms listed above may vary. With mitral stenosis, for example, dyspnea may be accompanied by hemoptysis and coughing, the patient may also suffer from edema of the extremities, irregularities in the work of the heart. Shortness of breath, general weakness and heart palpitations are symptoms of mitral valve insufficiency, and pallor, dyspnea, and pain during exercise indicate failure of the aortic valves.

All the above symptoms must be treated with all seriousness, as, as has been said, hypertrophy of the left atrium is not a disease in itself, it accompanies various heart diseases. The latter are a danger to the life and health of the patient.

Diagnosis of left atrial hypertrophy

Although, as is known, at the initial stage of cardiac tissue changes are asymptomatic, there are ways to diagnose left atrial hypertrophy.

First, this pathology can be detected by auscultation of the heart. Auscultation is a special method of diagnosis, based on listening and evaluation of sounds that arise during the work of various organs. In the case of cardiovascular diseases and pathologies, in particular hypertrophy of the left atrium, two types of sounds are heard with the help of a stethoscope - tones (short, sharp sounds) and noises (prolonged sounds). The appearance of noise and indicates problems in the work of the heart valves, and therefore, the presence of pathology.

Secondly, it is possible to diagnose hypertrophy of the left atrium by means of ultrasound, and specifically echocardiography, whose aim is to study changes in the heart and its valve apparatus. Thanks to the image obtained with the help of reflected ultrasound signals, the doctor can reveal the true state of the heart tissue and valves, establish the size of the heart chambers and the thickness of the heart walls, observe the rate of blood flow in the atria and ventricles and make the most accurate diagnosis of left atrial hypertrophy.

The third way to detect hypertrophy of the left atrium, especially with congenital heart diseases, is an X-ray study, with which the doctor can assess the condition of the lungs, reliably determine the size of the heart and its departments.

And finally, fourthly, it is possible to detect hypertrophy of the left atrium by carrying out an electrocardiogram, which reveals abnormalities in the contractions of the heart.

As a rule, the case is not limited to one of the above methods, because an integrated approach to examining a person with suspected hypertrophy of the left atrium allows you to get the most complete picture of the condition and work of the heart in general and the left atrium in particular.

[11], [12], [13]

Hypertrophy of the left atrium on ECG

One of the methods for diagnosing left atrial hypertrophy, as mentioned above, is electrocardiography. This is a well-known, inexpensive, but reliable method for identifying cardiac pathologies. The essence of it is to study the electric fields registered with the help of a special device, which are formed during the work of the heart and are fixed on the ECG. As a rule, the P, Q, R, S, T teeth are isolated on the ECG: the QRS complex reflects the contraction of the ventricular heart muscle, the T wave and the ST segment - the repolarization of their myocardium, and P - the coverage by the excitation of the myocardium of the atria.

To detect hypertrophy of the left atrium on the ECG, it is precisely the prong P that is of particular importance. With an increase in this part of the heart with excitation of the left atrium, EMF increases, which, accordingly, leads to an increase in the excitation vector of this heart chamber, and the excitation itself lasts longer. In the right atrium, nothing of the kind is observed, so on the ECG the first part of the P wave, reflecting the excitation of the right atrium, corresponds to the norm. But the amplitude and duration of the second part of the tooth, which reflects the excitation of the hypertrophied left atrium, is increased. As a result, P-mitrale is observed on the ECG (bifurcated elongated tooth P in the leads I, II, aVL, V5, V6), and the total width of this tooth exceeds 0.10-0.12 sec, and the amplitude of its second vertex is greater than the first.

Treatment of hypertrophy of the left atrium

Since this pathology is not an independent disease, treatment of hypertrophy of the left atrium presupposes, first of all, treatment of the underlying disease. Consequently, the effectiveness of treatment of hypertrophic changes in the heart muscle depends on how correctly the underlying disease is determined, leading to hypertrophy of the left atrium, as far as possible and effective treatment of it.

If the cause of hypertrophy of the left atrium was the infectious disease of the respiratory tract, the treatment is performed depending on the symptoms observed in the patient. Antiviral drugs are used if the left atrial hypertrophy is caused by a viral infection, antibiotics - with bacterial infection.

In the event that the enlargement of the left atrium is associated with increased pressure, the doctor prescribes the course of the appropriate antihypertensive drugs in order to lower the pressure (for example, carvedilol, metoprolol and others).

When the reason for hypertrophy of the left atrium is mitral valve insufficiency, the most common cause is rheumatism. In this case, it is necessary to detect and eliminate streptococcal infection as quickly and quickly as possible, for which the patient can prescribe bicillin intake during the year monthly.

However, not always it is possible to be limited to therapy. The case can also reach surgical intervention - when left atrial hypertrophy is associated with mitral stenosis in the second or third stage of development. One of the possible options under such circumstances is valvuloplasty - an operation during which the surgeon restores the valve. When the valve is severely damaged and it is impossible to restore it, it is replaced.

However, each case is strictly individual, therefore treatment of hypertrophy of the left atrium, including diet, lifestyle and image, drugs and their dosage, should be prescribed by the doctor after a full and comprehensive examination, based on the underlying cause of the disease, heart condition and degree of its defeat.

Prevention of hypertrophy of the left atrium

In general, advice on the prevention of hypertrophy of the left atrium is well known to everyone. The main one is a healthy lifestyle, however trite it may sound. A normal eight-hour sleep, a healthy diet without extreme diets and overeating, a regular but not excessive physical load is quite capable of preventing the development of dangerous pathologies, and most importantly, the diseases behind them.

Do not think that exhausting yourself on the simulators, you can avoid health problems. Quite the contrary, the athlete's heart is forced to work at the limit of the possibilities due to heavy loads, so the thickening of the heart tissue, rather, can be considered ordinary for the sports fan phenomenon, than the exception. And for those who simply want to avoid hypertrophy of the left atrium, it's enough to walk quietly before going to bed, swim, ride a bike or go skiing. Much useful is also brought by outdoor games: you can play badminton with friends or in a ball with a child - and then strong health and excellent mood will be provided.

It is also important to avoid stress, or at least to deal with it in a timely manner. But positive emotions, on the contrary, most favorably affect the patient's health, including in terms of preventing the development of hypertrophy of the left atrium.

In order to prevent left atrial hypertrophy, it is important to treat diseases that can lead to the development of this pathology in time and in full. If left atrial hypertrophy is already diagnosed, then immediately started treatment will help to avoid extremely unpleasant complications, including without the need for surgical intervention.

Prognosis of left atrial hypertrophy

Like treatment, the prognosis of left atrial hypertrophy largely depends on what causes the pathology, and on how much the heart is affected.

With early diagnosis, timely treatment, proper prevention in most cases of hypertrophy of the left atrium, one can avoid or minimize harm from it at a minimum, and the patient can safely enjoy a full life and not be afraid of the sad consequences for himself.

But we must not forget that hypertrophy of the left atrium can serve as a signal for the onset of more dangerous cardiac pathologies and provoke hypertrophic changes in other parts of the heart. So, with problems with the left atrium, the probability of increasing pressure in the left ventricle is high, and as a result, its hypertrophy may gradually develop. If the mitral valve is insufficient for increasing pressure in the left atrium, there is an increase in pressure in the pulmonary artery and, in many cases, hypertrophy of the right ventricle.

To the hypertrophy of the left atrium should be taken very seriously, because in the absence of appropriate treatment, the prognosis deteriorates significantly: this pathology can not only disrupt the habitual way of life, lead to complications and health problems, but also become a real threat to life. Thus, with far-reaching changes in the heart muscle, pulmonary edema may develop, and attacks of cardiac asthma may begin. In the worst case scenario, increasing circulatory problems can lead to disability or even death.

But do not think that hypertrophy of the left atrium has a uniquely negative prognosis. Even with congenital heart defects, even with the need for surgical intervention, patients can fully return to a full life without limiting themselves due to health problems. The main thing is not to delay the visit to the doctor, do not ignore the unfavorable symptoms, especially if to the hypertrophy of the left atrium there is a genetic predisposition, strictly follow the advice of doctors and undergo a full course of treatment, and often it is enough just to lead an active and healthy lifestyle, and then the prognosis of hypertrophy of the left the atrium will be the most favorable.