LEFT VENTRICULAR

HYPERTROPHY
• Hypertrophy of heart is defined as increase in
size & weight of the myocardium.

• It generally results from increase pressure load

while increase volume load in hypertrophy with
dialatation of the affected chamber due to
regurgitation of the blood through incompetent
valves
 It appears that streching of myocardial
fibres in response to stress induces the
cells to increase in length
 Others stimulating factors are anoxia
,influence of certain hormones ( CA s ,
Pituitatry growth hormone
Causes of LVH
• Systemic hypertension
• Aortic stenosis and insufficiency
• Mitral insufficiency
• Coarctation of the aorta
• Occlusive coronary artery disease
• Congenital anomalies like septal defects
and patent ductus arteriosis
• Conditions with increased cardiac output
e.g. thyrotoxicosis,anaemia,arteriovenous
fistulae
Pathological Changes

 Concentric Hypertrophy – hypertrophy of

the myocardium without dilatation.

 Eccentric hypertrophy – hypertrophy of

the myocardium with dilatation.
Gross Findings
 In concentric hypertrophy – lumen of LV
chamber is smaller than usual.

 In eccentric hypertrophy – the lumen of LV

chamber is dilated.

 In pure hypertrophy – the papillary muscles &

trabeculater carneae are rounded & enlarged.
Microscopic Findings
 Increase in size of individual muscle fibres.

 Multiple minute foci of degenerative changes &

necrosis in hypertrophied myocardium.

 Changes arises as a result of relative hypoxia of

hypertrophied muscle as the blood supply is
inadequate.
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