Right ventricular hypertrophy
Right ventricular hypertrophy is a condition in which there is an increase in the thickness of the walls and mass of the myocardium of the right ventricle. With various pathological conditions, the right ventricle is dilated and the mass of its walls increases (hypertrophy).
The main reason for the development of the right ventricular hypertrophy is the excessive strain on it. It appears with increasing blood pressure in a pulmonary circulation (pulmonary artery and its branches, pulmonary capillaries, pulmonary veins), as well as when discharging blood to the right ventricle with certain congenital heart defects.
In children, the development of the right ventricular hypertrophy is primarily associated with congenital heart disease.
In adults, the main cause of the right ventricular hypertrophy is the so-called pulmonary heart. Pulmonary heart arises in diseases that prevent normal breathing. As a result, the pressure in the pulmonary artery rises, the right ventricle experiences overload and increases. Causes of pulmonary hypertension and pulmonary heart disease:
- lung diseases (bronchial asthma, chronic bronchitis, emphysema, bronchiectasis, tuberculosis and others);
- chest diseases (curvature of the spine, poliomyelitis and others);
- pulmonary vascular disease (thrombosis and embolism, arteritis, compression of the vessels by the mediastinal tumor and others).
The right ventricular hypertrophy in adults sometimes occurs as a result of stenosis of the mitral valve. With this disease, the left ventricular function is disrupted, then the pressure in the pulmonary vessels rises and the right ventricle is damaged again. Tricuspid insufficiency also leads to the development of the right ventricular hypertrophy. In this case, a part of the blood from the right ventricle, when it contracted, falls not in the pulmonary artery, but back to the right atrium, and again into the right ventricle. It is forced to pump a large volume of blood and as a result it increases.
The right ventricular hypertrophy does not cause any complaints by itself. Clinically, only its causes (pulmonary hypertension) and complications (heart failure) are manifested.
Signs of pulmonary hypertension:
- dyspnea with insignificant physical exertion and at rest, dry cough;
- weakness, apathy, dizziness and fainting;
- heart palpitations, swelling of the cervical veins;
- hemoptysis;
- arrhythmia;
- anginal pain associated with oxygen starvation of the myocardium (compressing pain behind the sternum under physical exertion, often accompanied by a cold sweat, passing after taking nitroglycerin).
Signs of heart failure caused by decreased contractility of the enlarged right ventricle:
- heaviness in the right hypochondrium;
- appearance of enlarged veins on the skin of the abdomen;
- edema of the legs and anterior abdominal wall.
Congenital heart defects in children can be accompanied by cyanosis of the skin, shortness of breath and heart palpitations, arrhythmia, lag in growth and development.
Methods of diagnosis of the right ventricular hypertrophy:
- Electrocardiography does not always detect the right ventricular hypertrophy, especially at an early stage;
- Echocardiography, or ultrasound examination of the heart is the most informative method;
- Chest X-ray can provide additional diagnostic information for the pulmonary heart.
The right ventricular hypertrophy does not respond to treatment by itself. Treatment of the diseases causing it is being carried out. Some methods of non-drug treatment can be noted:
- Exclusion of heavy physical exertion and exercise, especially with pronounced right ventricular hypertrophy.
- Complete rest and sleep.
- Prevention of influenza, acute respiratory infections, exacerbations of chronic lung diseases.
- High altitude conditions are not recommended.
Pulmonary hypertension and chronic pulmonary heart often require constant medication.
Heart defects in children and adults are corrected by surgical intervention.
Insufficiency of blood circulation is treated according to the appropriate protocols.
