Fig

Hypertensive heart disease with marked concentric thickening of the left ventricular wall causing reduction in lumen size. The left ventricle is on the right in this apical four-chamber view of the heart. A pacemaker is incidentally present in the right ventricle (arrow). Note also the left atrial dilation (asterisk) due to relative stiffening of the left ventricle causing impaired diastolic relaxation and subsequent atrial volume overload.
Hypertensive LVH with Lt atrial dilation