Echocardiography of the heart

Echocardiography of the heart

Heart hypertrophy is not a disease, but a syndrome that can lead to serious heart disease. Myocardial hypertrophy is associated with an increase in the size of the heart. This happens due to an increase in the cells of the heart tissue. In fact, only specialized heart cells – cardiomyocytes – increase in size, which make up about 25% of the total number of heart cells, and connective tissue takes up most of it. In most cases, an increase in tissue size is an abnormal condition and is accompanied by additional cardiovascular diseases. The only exception is regular aerobic exercise, which also leads to physiological hypertrophy. Non-pathological enlargement of the heart is observed in athletes and people who lead an active lifestyle. This is due to the fact that the organs require more oxygen to function properly, which is supplied to the tissues through the circulatory system. In this case, the lower parts of the heart, namely the left ventricle, are subject to an increase in size, since it is he who participates in the release of blood into the systemic circulation.
As you know, the heart consists of four sections: two atria, into which blood comes from the circulation, and two ventricles, the function of which is to push blood into the bloodstream. Hypertrophy of different parts of the heart has its own characteristics, not only in origin, but also in symptoms.

Echocardiography of the heart
  1. Hypertrophy of the left atrium
    In the left atrium, blood comes from the lungs, it is enriched with oxygen and then transferred to the left ventricle, from where the blood spreads throughout the body.
    Causes of left atrial hypertrophy
    Left atrial hypertrophy is very often associated with genetic defects and therefore inherited. Obesity and high blood pressure are also important causes of this pathology.
  • Obesity. According to the latest data, obesity is increasing at an alarming rate in children, which makes them prone to this heart condition.
  • Mitral valve. The mitral valve opens when the left atrium is filled with a predetermined amount of blood, and it closes after the required amount of blood has been pumped into the left ventricle. There are two types of malfunction of this system – stenosis and mitral valve insufficiency. If the mitral valve is insufficient, it does not work properly, it does not close, even after all the blood has been transferred to the left ventricle. The inability of the mitral valve to close tightly leads to a flow of blood in the opposite direction – from the left ventricle to the left atrium. This phenomenon can lead to inflammation of the left atrium. Mitral stenosis is a narrowing of the opening between the two parts of the heart. In such cases, the left atrium has to work harder to pump the required volume of blood into the left ventricle. This overload causes left atrial hypertrophy.
  • Hypertrophic cardiomyopathy. As a rule, it is characterized by an unnatural thickening of the ventricles of the heart. This condition leads to excessive stress on the heart, as it is necessary to take more active efforts to provide a sufficient amount of blood to various parts of the body. This overload in the lower heart can cause an abnormal enlargement of the left atrium. Hypertrophic cardiomyopathy is an inherited disorder.
  • Aortic stenosis. Abnormal narrowing causes the valve to malfunction, thereby reducing the amount of blood leaving the heart. In this case, the left atrium also suffers.
  • High blood pressure. Blood pressure regulates the normal flow of blood through the vessels and keeps them in normal condition. Various factors lead to an increase in blood pressure, which puts more stress on the heart.
  • Pulmonary diseases. Any infection or disease of the respiratory system that significantly reduces the functionality of the lungs can also lead to left atrial hypertrophy.
  • Stress.
    Symptoms of left atrial hypertrophy
    Symptoms will depend on the degree of left atrial enlargement. If the increase is significant, then the person is more likely to experience side effects right away. Most often, with left ventricular hypertrophy, symptoms of the following nature appear.
  • Chest pain
  • Increased fatigue
  • Difficulty breathing
  • Abnormal heartbeat
    Left heart hypertrophy.
  1. Left ventricular hypertrophy
    Left ventricular hypertrophy develops in response to certain factors, such as high blood pressure, which causes the left ventricle to work harder. Given the large volume, the walls of the chamber increase, which eventually lose their elasticity and eventually stop working with the same force as in a healthy heart.
    Causes of left ventricular hypertrophy
    Since the left atrium and ventricle work in the same ligament, the reasons for the increase in the size of these sections are similar. These include:
Left ventricular hypertrophy
  • High blood pressure (hypertension). It is the most common cause of left ventricular hypertrophy.
  • Stenosis of the aortic valve.
  • Hypertrophic cardiomyopathy. There is an abnormal increase in the heart muscle.
  • Physical exercise. Intense, long-term strength training makes the heart work harder. And in order for the heart to cope with the additional load, it has to adapt. With the right approach and correctly aligned workouts, as well as monitoring the work of the heart, for example, using the Cardiovisor, athletes can avoid abnormal disorders. Otherwise, excessive physical activity can lead to irreversible consequences, such as a heart attack.
  • Obesity can cause high blood pressure and increased oxygen demand in the body, leading to hypertrophy.
  • Other diseases. Certain types of muscular dystrophy and Fabry disease associated with changes in the heart increase the risk of left ventricular hypertrophy.
    Left ventricular hypertrophy usually develops gradually. The patient may not experience any signs or symptoms, especially in the early stages of the disease. The main symptoms include:
  • Shortness of breath
  • Chest pain
  • Heart palpitations
  • Dizziness
  • Fainting
  • Rapid exhaustion with physical activity
    Complications of left ventricular hypertrophy
    The left ventricle is a connecting link with a large circle of blood circulation, which is responsible for the supply of blood to all tissues and organs, therefore, an increase in the size of this part of the heart leads to serious complications.
  • Heart failure. The inability of the heart to pump enough blood for the body to function properly.
  • Arrhythmia. Abnormal heart rhythm.
  • Coronary artery disease. Insufficient oxygen supply to the tissues of the heart itself.
  • Heart attack. Interruption of the blood supply to the heart.
  • Sudden cardiac arrest. Sudden, sudden loss of heart function, respiration, and consciousness.

Fig2. EchoCG of a child with hypertrophic cardiomyopathy. Left ventricular hypertrophy is especially pronounced.

  1. Hypertrophy of the right atrium
    Blood from organs and tissues that take oxygen and release carbon dioxide is directed to the right atrium. Then the blood enters the right ventricle, from where it is sent to the lungs in order to be enriched with oxygen. The right side of the heart is highly dependent on the work of the lungs, therefore, pathological changes in respiratory function can lead to changes in the work of the right atrium and ventricle.
    Causes of right atrial hypertrophy
  • Diseases of the lungs. Bronchitis, or chronic obstructive pulmonary disease, can cause high blood pressure in the pulmonary artery, which collects blood from the right ventricle. High blood pressure can eventually lead to hypertrophy.
  • Stenosis of the tricuspid valve. This valve is located between the right atrium and the ventricle. The tricuspid valve allows blood to circulate normally from the right atrium to the right ventricle. Stenosis (narrowing) of the opening between the two parts of the heart leads to a decrease in blood volume from the atrium to the ventricle. In order to restore normal blood flow, the right atrium must force blood into the ventricle with greater force. As a result of increased work, the walls of the atrium increase in size.
  • Tricuspid regurgitation, or tricuspid valve insufficiency. With this pathology, the valve does not completely close between the departments, as a result of which blood can be transfused from the ventricle into the atrium.
  • Pulmonary embolism. The pulmonary artery connects the right ventricle and the lungs. This artery carries oxygen-depleted blood to the lungs to cleanse and restore the required amount of oxygen. The main load is taken by the right atrium and ventricle.
  • Congenital heart defects. This is a congenital anomaly in the structure of the heart. The heart does not develop properly after 9 months of pregnancy. This defect disrupts the normal functioning of the heart. The most common defects are associated with the tricuspid valve, pulmonary valve, and mitral valve. All of them are an integral part of the myocardium.
    Any deformation in the structure of the heart can affect one or all of the valves, disrupting blood flow and ultimately causing hypertrophy.
  • Right ventricular hypertrophy. Very often, an increase in the size of this section leads to hypertrophy of the right atrium.
    Symptoms of right atrial hypertrophy
    The main ones include:
  • Fatigue
  • Chest pain
  • Breathing problems.
  1. Hypertrophy of the right ventricle
    Right ventricular hypertrophy is considered a fairly rare heart disease. Unlike left ventricular hypertrophy, the functioning of which is influenced by many factors.
    Causes of right ventricular hypertrophy
    There are four main reasons for this pathology.
  • Pulmonary hypertension. Leads to an increase in pressure
  • Tetralogy of Fallot. This is a type of congenital heart disease and causes blue baby syndrome. It is observed in children from the moment of birth and continues during the first year. In this disease, the outflow of blood from the right ventricle is impaired.
  • Pulmonary valve stenosis. Pulmonary stenosis causes disturbances in blood flow from the right ventricle to the artery.
  • Ventricular septal defect. With a defect in the interventricular septum, the blood of the two departments is mixed. Since in this case, mixed blood begins to flow to the organs and tissues, in which there is not enough oxygen. The heart is trying to restore normal nutrition to the body due to the increased work of its departments, including the right ventricle of the heart.
    Symptoms of right ventricular hypertrophy
    In the initial stages the patient may experience:
  • Difficulty breathing combined with chest pain and pressure.
  • Palpitations. There may be a feeling of flutter or that the heart has skipped a few beats.
  • Dizziness and possible loss of consciousness
  • Swelling of the lower extremities.

Fig 4. Severe RV dilatation with akinesia, LV hypokinesia

Conclusion
Heart echocardiography is a modern, highly informative, non-invasive, painless and safe method for diagnosing many diseases of the heart and blood vessels.
EchoCG allows you to study the structure of the heart and surrounding tissues, the aorta and the pulmonary artery, determines the size of the cavities and the thickness of the walls of the heart, assesses the work of the valve apparatus, reveals violations of the contractile function and relaxation function, characterizes the movement of blood flows inside the heart, as well as the state of the aorta and pulmonary arteries.
Echocardiography is used to determine the state of the pericardium and detect fluid in the pericardial region, detect blood clots in the cavities of the heart.
An echocardiogram is necessary to diagnose and determine the degree of left ventricular myocardial hypertrophy, which occurs in hypertension, and can also be a manifestation of an independent heart disease.

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