sudden cardiac death death from cardiac causes that occurs instantaneously or within the hour of the onset of symptoms; the hallmark features are an instantaneous and unexpected time and mode of cardiac death.
NUMEROUS STUDIES HAVE DOCUMENTED A strong relationship between hypertrophy of the heart and the risk of serious cardiac events. Hypertrophy is an increase of the essential tissue of an organ, for example, the muscle cells of the heart or of the biceps in a bodybuilder.
Such an increase may depend upon enlargement of the individual cells — hypertrophy proper — or they may be at the proliferation of the cells (hyperplasia) at the same time; the two conditions are often present together.

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• I. PATHOPHYSIOLOGY
  Physiologic, naturally occurring hypertrophy usually rep¬resents as an adaptation to increased functional demands, and a similar principle dominates pathologic hypertrophy. Hypertrophy of the heart affects the left ventricle and left ventricular hypertrophy is a feature of many forms of heart disease. The left atrium may, however, hypertrophy to assist a left ventricle that is under stress and strain imposed by pressure or volume overload. The right ven¬tricle may hypertrophy in patients with pulmonary artery hypertension or pulmonary valve stenosis. The right atrium may hypertrophy to assist the right ventricle and also be hypertrophied in patients with chronic obstructive pulmonary disease.
• II. CAUSES AND COMPLICATIONS OF HEART HYPERTROPHY
  A. Causes
• III. DIAGNOSIS
  The diagnosis of left ventricular hypertrophy and left atrial hypertrophy are readily made from electrocardio¬graphic findings. Figure 1 shows a normal ECG Figs. 2 and 3 show features of left ventricular hypertrophy.
• IV. PREVENTION AND MANAGEMENT
  Hypertension is the main cause of left ventricular hypertrophy and aggressive treatment of hypertension
• BIBLIOGRAPHY
  Carlberg, B., Samuelsson, O., Lindholm, L. H. et al. In hypertension: Is it a wise choice? Lancet, 364:1684–89, 2004.

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