Marly Humphrey,

Thanks for your question. 

There are several questions that come to mind concerning your son.  Is he very athletic?  Does he have any symptoms of shortness of breath? 

Left ventricular hypertrophy commonly develops as a response to long standing high blood pressure, but can occur in other situations.  Dilatation of the ventricle may indicate that the chamber is having difficulty emptying with each pump of the heart.   

Be sure to ask about any valvular abnormalities, which can be seen on an echocardiogram, and cause the situation described.  As part of this, ask if there is any heart murmur present.

Also, ask about hypertrophic cardiomyopathy, which is a buildup of muscle along the outflow tract where blood exits the chamber.  The buildup can become thick enough to actually obstruct the flow of blood, which can cause further hypertrophy of the ventricle and with time, also dilate the ventricle.  This situation often causes dizziness, and can affect young adults. 

Ask about his activity levels:  should they be curtailed?

What is the status of his cholesterol level.  If high, is treatment indicated?

With the stress test, ask whether there was any indication of blockages in his coronary arteries.

Ask whether an abnormal cardiac rhythm could be responsible for his dizziness.  Sometimes the situation you described could cause abnormal rhythms that could produce dizziness. 

If you have the right doctor, he/she should sit down with you and explain this whole situation in detail and answer all your questions.  Your son is very young, and doctors understand the impact this has on a young patient and the family.  Ask any other question that comes to mind.  The only stupid question is the one that is not asked.

Best wishes.

Martin Cane, M.D.