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Men's Health

Hypertension and cardiomegaly

09/19/2007

Question:

Some background information:

I`m a 34 male, a little over weight, but not obese. I was diagnosed with high blood pressure about 5 years ago (runs in the family). It’s been under control since then and generally runs about 125 / 80 to 132 / 87. I take Nifedipine (30mg), and Lisinopril (25mg) one time daily to control it.

I recently went to the doctor for a check up. While there, I told him that I had been experiencing some strange sensations in my chest. The best way I know to describe them is a sudden sinking feeling in my chest. It’s very noticeable, and uncomfortable. It only lasts for a few seconds (maybe 10 to 15 seconds). I’ve also been VERY tired for the last several months. I’ve been experiencing sharp muscle aches and pains that appear to be quite random, short of breath, and having headaches. My doctor ordered X-rays of my chest, as well as an EKG and blood work. The EKG was normal. It took a day to get the results, but I was told the X-ray showed an enlarged heart. I’m supposed to see a heart specialist next week for a stress test.

The blood tests showed my liver enzymes are “very high” (ALT’s). My LDL was 132, my HDL was 30, and my triglycerides were 183.

So, after all of that, my question is: How likely is it that my blood pressure is the cause of the enlarged heart… and perhaps the rest of my symptoms as well?

Answer:

High blood pressure can cause an enlargement of the left ventricle of the heart.  Because the workload of heart muscle is increased, the heat muscle increases in size, similar to the arm muscles of a person lifting weights.  Unfortunately, this increase in left ventricular muscle size is not healthy and after many years can lead to heart failure.

Good control of blood pressure and choice of the right medications can not only stop, but even reverse the enlargement of the left ventricle.

The best test to assess left ventricular size and function is an echocardiogram, followed by a stress test.  Your LDL cholesterol is in an acceptable range, and given your age, coronary artery disease is not very likely.  Hypertension, especially when controlled, does not cause symptoms.  In your case, other causes for your symptoms will have to be looked for.

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Response by:

Max C Reif, MD Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati