Update on left ventricular hypertrophy

Summary Detection and evaluation of left ventricular hypertrophy of unknown etiology by echocardiography is important in every cardiology practice. Causes of left ventricular hypertrophy include sarcomeric protein disorders (classical hypertrophic cardiomyopathy), metabolic disease (glycogen storage disease including LAMP2 deficiency, PRKAG2 mutations, Fabry disease), syndromic hypertrophic cardiomyopathy (Noonan’s syndrome, LEOPARD syndrome, etc.) and miscellaneous causes including systemic hypertension, amyloidosis, athlete’s heart and pheochromocytoma. Although there are several echocardiographic changes quite typical for some of the disorders, most changes are not 100% specific. ECG findings and symptoms provide important additional information. Genetic testing is increasingly important. Nowadays, a combination of ECG findings, symptoms, family history, genetic testing and findings of echocardiography provide the best means for differentiation of left ventricular hypertrophy.