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LEFT  VENTRICULAR  HYPERTROPHY  (LVH) NOOR HAFIZAH BINTI HASSAN 2007287236
INTRODUCTION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Progression From Hypertension to Heart Failure LVH, left ventricular hypertrophy; MI, myocardial infarction; CHF, chronic heart failure. Vasan RS and Levy D.  Arch Intern Med.  1996;156:1789-1796. Hypertension Smoking Dyslipidemia Diabetes Obesity Diabetes MI LVH LVF Normal LV Structure and Function LV Remodeling Subclinical LV Dysfunction Overt Heart Failure Diastolic Dysfunction Systolic Dysfunction
[object Object],[object Object],[object Object],Cardiac myocyte hypertrophy Deposition of extracellular matrix PATHOPHYSIOLOGY OF LVH IN HT
Continue.. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Deposition of ECM around the hypertrophied myocyte ↓ Inhibit the heart from contracting and relaxing normally The Normal Heart, Left Ventricular Hypertrophy in Hypertension, and Heart Failure in Hypertension Douglas L. Mann, MD, James L. Pool, MD, and Addison A. Taylor, MD, PhD Hypertensiononline.org.
Harrison’s Principle of Internal Medicine 16 th  ed, page 1369
NEJM 15 MAY 2003
CLINICAL PRESENTATION ,[object Object],[object Object],[object Object],[object Object],[object Object]
INVESTIGATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
OTHER MODALITIES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PHARMACOLOGICAL MX ,[object Object],[object Object],[object Object]
NON PHARMALOGICAL MX ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],MOH CPG on Management of Hypertension, 3 rd  ed 2008
Progression From Hypertension to Heart Failure LVH, left ventricular hypertrophy; MI, myocardial infarction; CHF, chronic heart failure. Vasan RS and Levy D.  Arch Intern Med.  1996;156:1789-1796. Hypertension Smoking Dyslipidemia Diabetes Obesity Diabetes MI LVH CHF Normal LV Structure and Function LV Remodeling Subclinical LV Dysfunction Overt Heart Failure Diastolic Dysfunction Systolic Dysfunction

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Lvh

  • 1. LEFT VENTRICULAR HYPERTROPHY (LVH) NOOR HAFIZAH BINTI HASSAN 2007287236
  • 2.
  • 3. Progression From Hypertension to Heart Failure LVH, left ventricular hypertrophy; MI, myocardial infarction; CHF, chronic heart failure. Vasan RS and Levy D. Arch Intern Med. 1996;156:1789-1796. Hypertension Smoking Dyslipidemia Diabetes Obesity Diabetes MI LVH LVF Normal LV Structure and Function LV Remodeling Subclinical LV Dysfunction Overt Heart Failure Diastolic Dysfunction Systolic Dysfunction
  • 4.
  • 5.
  • 6. Harrison’s Principle of Internal Medicine 16 th ed, page 1369
  • 7. NEJM 15 MAY 2003
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14. Progression From Hypertension to Heart Failure LVH, left ventricular hypertrophy; MI, myocardial infarction; CHF, chronic heart failure. Vasan RS and Levy D. Arch Intern Med. 1996;156:1789-1796. Hypertension Smoking Dyslipidemia Diabetes Obesity Diabetes MI LVH CHF Normal LV Structure and Function LV Remodeling Subclinical LV Dysfunction Overt Heart Failure Diastolic Dysfunction Systolic Dysfunction

Notas del editor

  1. Hypertension can lead to LVH, diastolic or systolic dysfunction and heart failure. Progression from hypertension to LVH is due to the macro and micro changes in the ventricle (LV remodeling). This remodeling can lead to diastolic dysfunction without clinical signs or symptoms of heart failure. This emphasizes the importance of treatment in some patients prior to development of overt heart failure. Hypertension, in conjunction with other risk factors for atherosclerosis may lead to myocardial infarction. LV remodeling again takes place, but does so differently, leading to systolic dysfunction. Again, remodeling is taking place within the ventricle in response to the injury but may not lead to overt heart failure. Progression will lead to heart failure, with decreasing ejection fractions.
  2. Hypertension can lead to LVH, diastolic or systolic dysfunction and heart failure. Progression from hypertension to LVH is due to the macro and micro changes in the ventricle (LV remodeling). This remodeling can lead to diastolic dysfunction without clinical signs or symptoms of heart failure. This emphasizes the importance of treatment in some patients prior to development of overt heart failure. Hypertension, in conjunction with other risk factors for atherosclerosis may lead to myocardial infarction. LV remodeling again takes place, but does so differently, leading to systolic dysfunction. Again, remodeling is taking place within the ventricle in response to the injury but may not lead to overt heart failure. Progression will lead to heart failure, with decreasing ejection fractions.