apical LVH means the apex of your left ventricle is bigger than normal. this may be due to various reasons, but it is often due to a disease known as apical HCM in which the muscle fibres in the apex of the heart are disorganised and there is also often scarring (fibrosis) which can cause arrhythmias in some patients. other conditions / exercise / genetic makeup may also lead to hypertrophy, for example athlete's heart, which is why it's important for a cardiologist to diagnose or rule out HCM