How hypertension can cause hypertrophy to the heart and damage it?

I am glad that you asked this question. In this article, I will be talking about changes that occur to the heart as a result of different diseases and including hypertension.

There are 2 kinds of hypertrophy that can happen to our heart: concentric and eccentric. They depend on what diseases you have.

The first type is the concentric hypertrophy. In this type, the myocardium becomes so thickened that it can’t relax and is filled hardly. Consequently, as the atrium contracts, this produces a heart sound called S4 that can be auscultated using the stethoscope.

Here is how it looks. As you see, the ventricle is just so so thick. It makes it very hard to fill this ventricle and, as a result, the cardiac output decreases. With time, this can precipitate diastolic heart failure.

What are the causes of concentric hypertrophy? They are many. The idea here is that anything that increases the afterload on the heart, it increases the work the heart needs to push blood. With time, the heart thickens. It is similar to going to the gym, as you put more pressure on your muscles, they grow more and more to withstand the high pressures you apply. However, when talking about the heart, it is pathological conditions and leads to pathological hypertrophy. Things that cause concentric hypertrophy include (but not limited to): Chronically elevated blood pressure (Hypertension,) Aortic stenosis, Congenital coarctation of the aorta

Heart hypertrophy also follows Laplace law which states that : (Tension applied on the heart all = 2x pressure applied on the heart / the radius (t=2p/h)

T should be constant. So if you increase P (afterload), you have to decrease H (wall thickness.) Decreasing wall thickness is just another word for hypertrophy

Eccentric hypertrophy occurs when there is volume overload on the heart. It is different from the concentric. In concentric, there is increased pressure that heart has to pump against. In eccentric, it is just the heart that is chronically overloaded with excess blood that it can’t handle. It results in a dilated heart that can’t efficiently pump blood. This is different from concentric hypertrophy which results in a very thick heart that can’t be filled at all.

Dilated hearts have many causes: It can be infectious like being infected with the coxsackie B virus. It can be due to chronic valvular disease that makes the blood regurgitate to the ventricle and this makes it overfilled with blood.

In the end, both eccentric and concentric can lead to congestive heart failure and increases your risk for other cardiac diseases like coronary artery disease and more

Comments

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