Left ventricular hypertrophy as a sign of cardiovascular disease

Dear Ask The Doctor: Hello. I'm (only) 23 years old male, slightly overweight (haven't scaled myself recently, but could lose 5 kilos or so), not very fit, trying to quit smoking (have already been more than a week without a cigarette), light drinker, not taking any other drugs, probably slightly neurotic. I have been feeling random long-lasting chest pains, dizziness, shortness of breath and light-headedness for about three years now. First I was diagnosed (wrongly, I think now) with panic attacks and was treated with anti-depressants. Symptoms didn't go away, so I visited cardiologists a few times. They found nothing significant, except that my heart was enlarged a bit. They ensured it's nothing serious and I can just carry on with my life. Last time, about three months ago, symptoms got so bad that I went to ER. They did tests and assured me it wasn't a heart attack. I cared less and symptoms were only slight, not annoying for a few months. Then about two weeks ago I started feeling strange feeling of weakness in my left leg and arm, also with chest pains, palpitations, dizziness, confusion and all the bad symptoms. I went to doctor yesterday and showed her my ECG from few months ago. Apparently, I might have left ventricular hypertrophy and these symptoms might mean I also have heart failure. She said I could have a heart attack soon. These were all very scary prognoses, but I'm trying to cope with them, even if it's hard to do that. I am having proper tests on Monday (the day after tomorrow), but... But after googling LVH and heart failure, I'm freaking out. There are some questions to which I need proper, honest answers, because I can't sleep at night thinking about them... Is it possible for me to die suddenly? I feel weakness and dizziness and shortness of breath, but I'm keeping pretty well, I don't faint and I can carry on with daily activities. Should I always stay around people, so that if anything, I can get help? If my heart beats slower than normal (about 50 bpm), does it mean my chances are worse? Should I keep myself from physical activity (such as walking, staying up late, sex) until I get test results? Really, what should I do until Monday so that I would not die suddenly? Is my young age a plus or a minus? What can be done against LVH? Can it be too advanced for medical science to take care of it? I really appreciate your help, as I'm getting crazy from all the fear I have and feel fairly hopeless... And please, be honest, if need be, be cruel.

Dear Tomas: Left ventricular hypertrophy can result as a reaction to aerobic exercise especially in athletes, but it often can be secondary to high blood pressure, a narrowed heart valve, and a sign of cardiovascular disease. Heart rate of less than 60 per minute is referred to as bradycardia, or a slow heart rate. If your heart rate is less than 60 and beating in a regular sinus rhythm, this may be normal in someone of your age. Heart attacks in someone of your age group are very rare, unless there is a history of congenital heart disease. LVH is treated by identifying the underlying cause and focusing treatment on reversing this cause. With the symptoms you describe of dizziness, lightheadedness, shortness of breath there are several investigations that are required to reach a diagnosis and may include an ECG, a 24 hour Holter (heart) monitor, an echocardiogram. These will investigate what rhythm your heart is beating in, show evidence of any heart rhythm abnormalities, check heart valve function and ventricular function, and visualise any structural abnormalities in the heart. I advise having these investigations performed and discussing the results with your cardiologist, before jumping to diagnoses, which may not be applicable in your case.