Does mild LVH cause sudden palpitation and dizziness?

Question

Hello doctor,

I am a 26-year-old male. I regularly exercise, but one night I suddenly experienced palpitations, dizziness, and high blood pressure, so I went to the emergency room. My ECG was normal, showing sinus tachycardia, and several tests were done afterward. My lipid profile was normal, with no diabetes or cholesterol issues, and my TMT was negative. However, my echocardiogram showed mild left ventricular hypertrophy (LVH). My doctor reassured me that my heart was fine and there was no problem, attributing the symptoms to anxiety. I would like to ask if mild LVH is a concern, as I often feel anxious about my heart health.

Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

I believe when you mention regular exercise, you are referring to both muscle-building activities and aerobic exercises. The symptoms you described were sudden-onset palpitations associated with continuous dizziness, and by the time you reached the ER, the palpitations had settled. Is that correct? You had a normal ECG (taken when the symptoms subsided) and a normal TMT. Although these results are reassuring, they do not completely rule out disease. Now, your echocardiogram revealed mild left ventricular hypertrophy (LVH). Based on the assumptions above, my assessment includes the following possible diagnoses, listed in order of likelihood:

Normal: Although I have not seen the echocardiogram films or the report, assuming it shows mild concentric LVH, this can be found in athletes and is nothing to be worried about. This is the most likely scenario, so you can rest assured.
Supraventricular tachycardia: This could have been the cause of the palpitations, which subsided by the time you reached the ER, leaving only a fast heart rate due to anxiety. This is a less likely possibility, but it is not a cause for concern, as this condition is usually intermittent and not dangerous. It is often diagnosed when symptoms are occurring, and if you had no symptoms during the ECG, it becomes even less likely.
Ventricular tachycardia: In a structurally normal heart, this is extremely unlikely. This condition is benign in a normal heart.

In conclusion, your doctor was correct. Most likely, this was just regular sinus tachycardia. Please follow these recommendations:

Continue with your regular exercise routine.
Maintain a healthy lifestyle, avoiding smoking.
Follow a low-carbohydrate diet and keep your body weight within a healthy range (BMI < 25.5 kg/m²).

Rest assured that your heart health is not a cause for concern.

Thank you.