Left ventricular hypertrophy on echocardiogram: When it is more than just physiological

Banya Aung Myint
25/05/2025

Take home messages

  • Left ventricular hypertrophy (LVH) exists on a spectrum from physiological adaptation to pathological remodeling.
  • LVH in cardiomyopathies can overlap with other causes. Accurate identification is therefore crucial for appropriate management, especially with the emergence of new treatment options.
  • Key echocardiographic features, clinical history, and ECG findings are crucial in distinguishing pathological LVH from physiological variants, guiding further evaluation.
  • A comprehensive, multimodality approach including the use of advanced imaging, is useful in identifying underlying cardiomyopathies.

Left ventricular hypertrophy (LVH) is a frequent echocardiographic finding and can represent either an adaptive physiological response or an indicator of underlying disease. Differentiating between these forms is crucial for identifying cardiomyopathies that require further evaluation. Echocardiography remains the first-line imaging tool for assessing LVH, offering key insights that can guide the need for advanced imaging.