I. Pathophysiology
II. Causes and Complications of Heart Hypertrophy
III. Diagnosis
IV. Prevention and Management

GLOSSARY
afterload arterial impedance, restriction to blood flow delivered from the left ventricle; force against which the myocardium contracts in systole; a major determinant of wall stress.
arrhythmia general term for an irregularity or rapidity of the heartbeat, an abnormal heart rhythm.
cardiomyopathy heart muscle disease.
concentric hypertrophy diffuse generalized thickening of the myocardium with little or no change in dimensions of the left ventricular cavity as seen in pressure overload of the left ventricle.
eccentric hypertrophy hypertrophy with concomitant enlarge¬ment or dilatation of the ventricular cavity, as seen in volume overload of the left ventricle.
heart failure failure of the heart to pump sufficient blood from the chambers into the aorta; inadequate supply of blood reaches organs and tissues.
myocardial infarction death of an area of heart muscle due to blockage of a coronary artery by blood and atheroma; medical term for a heart attack or coronary thrombosis.
sarcomere the contractile unit of a myofibril; sarcomeres are repeating units, delimited by the Z bands, along the length of a myofibril that make up the myocardium of the heart.

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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.