Introduction:
The human heart has two lower chambers called ventricles; one is the left ventricle, and the other is the right ventricle. These ventricles contain muscle pieces that go into heart chambers. These are known as trabeculations. When the heart develops, the muscles are sponge-like, and as development progresses, the muscles convert from sponge-like to solid. If the heart muscles in the left ventricle are not compacted and do not transform into a solid form, it can lead to left ventricular hyper trabeculation (LVHT). The most common area for LVHT is the bottom of the heart, but it can also be seen anywhere in the heart. The left ventricle is the vital area of the heart that contains oxygenated blood, pumped all over the body. If there is any alteration in the left ventricle, then it may impact cardiac function. The advancement in cardiac imaging techniques improved the left ventricular hypertrabeculation.
What Are Left Ventricular Hypertrabeculation in Athletes?
Left ventricular hypertrabeculation is a heart condition that affects athletes and non-athletes. The smooth muscle lines the wall of the heart's lower chambers, which helps in effective blood pumping. These smooth muscle lines are called trabeculations. When an athletic person does a prolonged exercise, the trabeculations in the left ventricle increase, leading to the formation of LVHT. The condition is challenging to differentiate between physiological and pathological LVHT. The other name of LVHT is left ventricular non-compaction cardiomyopathy (LVNC).
What Are the Causes of Left Ventricular Hypertrabeculation in Athletes?
Research to know the causes of LVHT is ongoing, but some factors that believe to be the reason for the development of LVHT in athletes are as follows:
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Physiologic Cause: During training or preparing for competition, the athletic person does intense and prolonged exercise leading to changes in the heart muscle. During intense exercise, the heart will pump more blood and oxygen, causing an increase in trabeculation in the left ventricle.
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Genetic Cause: The gene mutations in some people can affect heart development, leading to increased muscle mass in the left ventricle. There are 20 to 30 % of chance of genetic cause that results in the condition formation.
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Environmental Factors: The factors such as climate, altitude, and training conditions that may affect the heart of athletes can influence the development of the condition.
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Hemodynamic Stress: During an intense exercise, the heart's workload increases, leading to changes in pressure and blood flow patterns changes in the heart. This will contribute to the development of the condition.
What Are the Signs and Symptoms of Left Ventricular Hypertrabeculation in Athletes?
Some athletes with left ventricular hypertrabeculation show symptoms, and some do not. A healthcare provider must differentiate LVHT from other heart conditions or exercise-causing adaptations. The potential signs and symptoms that an athlete experiences are as follows:
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Asymptomatic: Generally, athletes with LVHT do not experience any symptoms. The condition is usually diagnosed during daily heart check-ups or medical evaluations.
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Chest Pain or Discomfort: Some athletes experience symptoms related to LVHT, such as chest pain or discomfort. The pain can be mild to moderate. It is important to differentiate whether the pain is due to LVHT or angina.
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Dyspnoea: The condition is also called shortness of breath. Some athletes may feel discomfort or shortness of breath during physical activity, mainly during exertion or vigorous exercise.
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Palpitations: Athletes may experience rapid or irregular heartbeat associated with the condition.
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Fatigue: In some cases, athletes may experience decreased exercise tolerance or fatigue.
How Are Left Ventricular Hypertrabeculationsin Athletes Diagnosed?
The diagnosis of LVHT is challenging because athletes do not experience symptoms associated with the condition. The symptoms are associated with other medical conditions. So, it is required to consult an experienced healthcare provider who detects the heart condition. The diagnosis needs a comprehensive evaluation that requires clinical assessment, cardiac imaging tests, and other diagnostic tests. The diagnosis needs to differentiate between physiological and pathological LVHT. The steps that detect the condition are as follows:
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Clinical Assessment: The healthcare provider will ask the patient about any previous heart condition, symptoms, exercise habits, and any family history of heart conditions. By doing this, the healthcare provider will learn about any risk factors that elevate the chances of developing the condition.
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Cardiac Imaging: The imaging techniques are used to evaluate the structure and function of the heart. The healthcare provider may advise the patient for echocardiography. The imaging test will find excessive trabeculations.
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Cardiac Magnetic Resonance Imaging (MRI): The cardiac MRI will provide a detailed view of the heart, which will help assess the heart's structure and function. The trabeculations in the heart are visualized in the left ventricle in athletes.
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Electrocardiogram (ECG): The ECG will detect abnormal heart rhythms associated with LVHT.
How Are Left Ventricular Hypertrabeculation in Athletes Managed?
Managing left ventricular hypertrabeculation in athletes can be done by collaborating with experienced healthcare professionals in sports. The aspects of managing LVHT in athletes are as follows:
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Clinical Evaluation: The healthcare professional will clinically evaluate the cardiac health of athletes, including the symptom assessment.
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Lifestyle Modifications: The healthcare provider may advise the patient to follow a healthy lifestyle diet, manage stress, limit alcohol consumption, take sufficient sleep, and avoid smoking.
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Exercise Recommendations: The healthcare professional may recommend some exercises for athletes. It includes normal regular physical activity and high-volume training.
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Medications: The doctor may prescribe anti-hypertensive or antiarrhythmic medications to manage symptoms.
How Are Left Ventricular Hypertrabeculations in Athletes Prevented?
The preventive measures will help decrease the risk of LVHT in athletes by maintaining heart health. The preventive strategies to promote heart health are as follows:
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Screening: The screening will help find pre-existing heart conditions by physical examination and medical history assessment.
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Regular Heart Check-Ups: Athletes should undergo regular heart check-ups to monitor their heart activity.
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Exercise Guidelines: The healthcare provider will recommend some exercise guidelines to athletes based on their health status, age, and fitness level. The main thing is to avoid excessive strain on the heart.
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Education and Awareness: Athletes should be informed about heart health and risks related to vigorous exercise.
Conclusion:
In conclusion, LVHT in athletes is a heart condition cause more trabeculations in the left ventricle. The cause of the condition can be genetic, environmental, and physiologic. It is difficult to differentiate between physiologic LVHT in athletes and pathologic one. Cardiac imaging techniques such as echocardiography and cardiac MRI help detect and monitor the condition. The management strategies include exercise recommendations and lifestyle modifications. More research is needed to know the proper cause of the condition in athletes.
