Enlarged right ventricle of the heart what is it

The departments of the heart can increase for various reasons. According to the medical definition, right ventricular hypertrophy is an increase in the myocardium or thickening of the walls of blood vessels. A change in size indicates an abnormal growth of heart cells (cardiomyocytes). The difference between a hypertrophied myocardium is that the vessels cannot nourish an overgrown organ.

There are 3 degrees of hypertrophy:

  1. Moderate – increase slightly. It has the same dimensions as the left.
  2. Medium – processes in this area of ​​the heart proceed more slowly.
  3. Pronounced – the right side is 2-3 times larger than the similar left.

Right ventricular hypertrophy

Ventricular hypertrophy (in other words, right ventricular myocardial hypertrophy or right ventricular hypertrophy) is a heart condition in which the right ventricle undergoes a change in size as a result of an increase in muscle tissue (heart fibers), and this in turn leads to congestion of the heart.

An increase in the ventricle of the heart occurs in people of different ages, but most of it is diagnosed in children. It is worth noting that cardiac hypertrophy can be observed in newborns, because they have increased heart function in the first days of life and on the right side of the heart.

As you know, a person’s heart has four chambers and two right parts of the heart regulate the work of the pulmonary circle of blood circulation, also called small. And the two left parts are responsible for the work of a large circle, or system. In a normal state of the heart, blood pressure in the right sections is less.

If a person has congenital heart defects or some kind of malfunction of the heart, then this rule is violated, which leads to an overload of the right ventricle of the heart, since it accounts for a greater blood flow than expected, and then its hypertrophy.

An increase in the right side of the heart is observed in people of different ages. Most often, such a pathology is diagnosed in babies. This is due to the fact that in the first years of life, the child’s body is growing rapidly, respectively, his heart is under increased stress.

When the disease is acute, then this indicates the presence of congenital heart disease. Such a diagnosis can be made on an ECG. Hypertrophy of the right ventricle of the heart can be acquired. Often, such changes are associated with an improper lifestyle, malnutrition, constant stress.

The right ventricle is enlarged, since it is he who is responsible for the large flow of blood, that is, undergoes a greater load and, under certain circumstances, more quickly fails. Some signs directly indicate that the heart muscle is overloaded and depleted, unable to cope with the amount of work that is assigned to it by the body.

Often a person himself overloads the heart without even thinking about it. The occurrence of hypertrophy can lead to problems in the work of the heart. Because of this, arrhythmia occurs, that is, the heartbeat is not even, but chaotic, the heart beats faster, then slower, regardless of human activity.

Arteries harden and do not pass through some substances. Over time, these substances accumulate and form obstacles to the passage of blood. So there are stagnations that lead to the formation of blood clots.

In Russia, 1 million 300 thousand people die every year from diseases of the cardiovascular system. At the same time, from 2 to 5 people per 100 of the population suffer from such a serious disease as cardiac hypertrophy.

And about half of them are between the ages of 20 and 35. Patients are diagnosed with hypertrophic cardiomyopathy, in abbreviated form, the disease is designated as HCMP. This is the primary myocardial lesion in which the left or right ventricles increase in volume.

At the same time, doctors divide HCMP into symmetric and asymmetric.

This is a typical disease among hypertensive patients. With proper treatment, left ventricular hypertrophy of the heart quickly ceases to be a problem. However, if everything is left to chance, then a fatal outcome is inevitable. According to statistics, 4% of cases end in death. The danger of the disease is that hypertrophy of the left ventricle of the heart significantly worsens the elasticity of the wall.

Causes of an increase in the left ventricle of the heart:

  • Hypertension with hypertension. The muscle fibers of the myokrad are deformed due to too high a load on the ventricle.
  • Various heart defects. Especially often the cause is a narrowing of the aortic valve.
  • Atherosclerosis of the aorta. In this case, the left ventricle is constantly overloaded.

The problem with this pathology is that only the myocardium becomes larger. In this case, the vessels and elements of the conductive system do not change their size. This gradually leads to the development of muscle cell ischemia. The heart rate goes astray, and a lot of blood accumulates in the left ventricle. Over time, this leads to:

  • heart failure;
  • blockades;
  • ventricular arrhythmias;
  • heart attack.

– an increase in the right ventricle with the development of heart failure resulting from diseases of the lungs or their vessels.

Chronic pulmonary heart develops with emphysema, pneumosclerosis, pneumoconiosis and a number of other chronic lung diseases.

In its origin, the increase in pressure in the pulmonary artery up to 100/70 mm Hg is of primary importance. Art. instead of 25/15 mm is normal.

In most cases, the clinical picture is dominated by symptoms of the underlying pulmonary disease and associated respiratory failure: shortness of breath, cyanosis, cough, etc. Manifestations of chronic pulmonary heart consist of signs of pulmonary hypertension, hypertrophy and dilatation of the right ventricle and circulatory disorders in a large circle.

Clinically, for the recognition of pulmonary hypertension, as well as the assessment of its severity, the emphasis is on the II tone on the pulmonary artery, radiological signs of the expansion of its main trunks, electrocardiographic signs of overload of the right atrium and ventricle (deviation of the electrical axis of the heart to the right, the appearance of high sharp teeth PI] _I) I )

In severe cases of pulmonary hypertension, diastolic murmur in the pulmonary artery is noted. Instrumental methods of research (electrocography, rheography, etc.) help indirectly assess the degree of pulmonary hypertension.

When examining a patient, pulsation of a hypertrophied right ventricle in the epigastric region can be palpated, which should be distinguished from the pulsation of the liver of the abdominal aorta.

For the diagnosis of chronic pulmonary heart, it is especially important to identify signs of circulatory disorders in a large circle in the form of an enlarged liver, swelling of the cervical veins, swelling in the legs, ascites, and a stagnant kidney with proteinuria. At the beginning of the disease, signs of heart failure can be expressed mildly and periodically disappear.

Treatment of patients with chronic pulmonary heart consists in reducing respiratory failure, reducing pulmonary hypertension and therapy of chronic heart failure (see).

Prevention of chronic pulmonary heart disease consists in timely active treatment of the underlying disease with the main focus on the restoration of bronchial obstruction. Important early detection and treatment of pulmonary hypertension with the use of diuretics, chloracisin, eufillia, oxygen therapy.

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Symptoms

Symptoms of right ventricular hypertrophy are uninformative in the initial stage of the disease. Among the recorded conditions, swelling of the lower extremities, systematic fainting, dizziness, shortness of breath, pain and heaviness in the chest area, shortness of breath are noted.

Causes

The causes of right ventricular hypertrophy are directly related to concomitant diseases. First of all, disturbances in the normal functioning of the heart (including various congenital pathologies) can provoke this ailment.

Other causes of right ventricular hypertrophy are also noted:

  • High blood pressure;
  • Cardiomyopathy
  • Bronchial asthma, pneumonia, bronchitis;
  • Systematic stress;
  • Weight gain;
  • With a defect in the septum between the ventricles, the blood from the two departments mixes. Organ systems and tissues receive oxygen-unsaturated blood and an excessive load on the right ventricle occurs.
  • Pulmonary hypertension, which is accompanied by fainting and shortness of breath. In this condition, an increase in pressure in the pulmonary artery is observed.
  • This symptom develops with Tetrad Fallot, a congenital pathology that promotes outflow from the right ventricle. A child born with such a syndrome is characterized by blueness of the skin. This defect is observed throughout the year since the birth of the baby.
  • This condition can occur as a result of pulmonary valve stenosis and impaired blood flow from the right atrium.

Depending on the degree of increase in the right part of the organ, the ailment is: moderate, moderate, sharp in severity.

In addition, there are other types: physiological – observed in children born; pathological – observed with burn injury or pneumonia, various pulmonary ailments, genetic imperfections, is formed due to sharp overloads of the body.

Prevention

Prevention measures come down to activities that help prevent the progression of phlebothrombosis in the legs.

To do this, you should diagnose the pathology in the early stages of its evolution and immediately proceed to physiiatry, conduct regular examinations in the hospital to exclude the increased risk of the disease.

The patient in the postoperative period with a diagnosis of “phlebothrombosis of the extremities” must lead an active life to prevent the process of stagnation of blood, while bandaging the operated leg with an elastic bandage. It is important that the entire protocol prescribed by the attending physician is followed.

Varieties

In a normal state, the mass of the right ventricle of the heart is three times less than the mass of the left. Depending on the degree of ventricular enlargement, three types of hypertrophy of the right ventricle of the heart are distinguished – moderate, moderate and pronounced. With moderate hypertrophy, the mass of the right ventricle is significantly less than the mass of the left.

In addition, we can distinguish such types of hypertrophy as physiological and pathological. Physiological hypertrophy is observed in children from the first days of life. Pathological – with congenital heart defects, various pulmonary diseases, as well as with sudden overloads, such as a burn disease or acute pneumonia.

A little physiology

It is known that the human heart has four chambers: it consists of two atria and two ventricles. Normally, all cavities are isolated from each other. The heart is a muscle pump that acts in a specific sequence due to the cardiac conduction system and myocardial contractility. The work cycle looks like this:

  • the left ventricle throws oxygen-rich blood into organs and tissues – into a large circle of blood circulation;
  • blood, passing through increasingly smaller arteries, enters the capillary network, where gas exchange occurs and changes color to dark, enters the small veins, then into the large veins that flow into the right atrium;
  • from the right atrium, which performs the function of a venous “cistern”, it flows during diastole (relaxation) into the right ventricle;
  • the right ventricle during contraction with force ejects venous blood into the pulmonary artery into the pulmonary circulation, which is located in the lungs to saturate it with oxygen;
  • red, oxygen-rich blood is collected in the pulmonary veins, and then through the pulmonary veins into the left atrium;
  • blood is ejected from the left atrium into the left, the strongest ventricle, and now it is ready to repeat the whole way – the circulation circles are closed.

Many are perplexed: why is the pulmonary artery called an artery, although venous blood flows in it, and, conversely, the pulmonary veins are called veins, but contain bright red arterial blood? The answer is very simple: the basis of the nomenclature is not the color and composition of the blood, but the nature of the location of the vessels: all the vessels that enter the atria are veins, and all that flow from the ventricles are arteries.

We told this in order to have a clear understanding that the heart muscle does not work at all as a whole: the left ventricle provides oxygen to the whole body, and the right one directs blood to the lungs.

Aftermath

The right departments of the heart work with a small circle of blood circulation, which is characterized by small loads. Hypertrophy of the right ventricle occurs as a result of significant overload. Its appearance most often indicates that the myocardium of the heart can not cope with the increased load, which in turn is fraught with arrhythmias, impaired contractility and other negative consequences.

Main types of pathology

The disease itself is divided into several types that distinguish the course of the pathology, signs and symptoms.

  1. Rapidly developing hypertrophy.

It is observed when the mass of the right side of the heart is several times larger than the left side.

The disease is moderate.

It is observed if the processes taking place on the right side of the heart muscle are slowed down and lag behind the processes on the left side. They should not be observed asynchronous operation.

There is nothing wrong with the detection of this disease. Timely and proper treatment will help get rid of the problem. When diagnosing, there is a slight increase in the right area.

In the initial stages, there are no symptoms. That is why timely diagnosis is difficult. In order to avoid the latent form of the disease, it is necessary to perform an ECG once a year. To identify the first stages of pathology in babies, intrauterine CTG and ECG are prescribed after the first year of life.

On an ECG, right ventricular hypertrophy is well defined. Every functional diagnostics doctor, cardiologist and therapist knows the ECG signs of right ventricular hypertrophy, we will analyze the main ones and we:

  1. In assignments of V1 V2 III aVF increase in height of a tooth of R;
  2. The ST bias is slightly lower than the contour, negative or bumpy T in V1 V2 III aVF;
  3. Pravogramma (EOS rejected to the right).

These are the main signs of an increase in the right ventricle, according to which pathology can be suspected. ECG right ventricular hypertrophy for people over 30 has the following diagnostic criteria:

  • Deviation of EOS to the right more than 110 degrees;
  • High R-teeth in V1 (more than 7 mm), S-teeth in V1 less than 2 mm, R / S in V1 more than one;
  • The S wave in V5 and V6 is greater than or equal to 2 mm;
  • complexes of type qR in V1.

If there are two or more of these criteria on an ECG, right ventricular hypertrophy may be exposed. Doctors also remember the confirming signs of right ventricular hypertrophy, which include:

  • changes in the ST segment and T wave according to the type of “overload” in leads V1-V3,
  • an increase in the right atrium.

Treatment

An accurate diagnosis can be made only after the entire complex of diagnostic measures. Only then can treatment be started. Diagnosis is as follows:

    Medical examination. Without it, no examination can be started.

As a rule, it is a thorough medical examination that can suggest that a person develops hypertrophy. Typically, a cardiologist with experience and diagnosis of such patients can easily hear pathological murmurs in the region of the heart with a simple listening.

  • Cardiography. Hypertrophy of the right ventricle on an ECG is noticeable by numerous specific changes. However, on the ECG, the doctor sees only a rhythm disturbance, but not an increase in the size of the ventricle. Accordingly, the latter can cause numerous malfunctions in the heart rhythm.
  • A thorough analysis of the anamnesis, the collection of complaints may suggest the development of this hypertrophy.
  • Echo cardiography is an ultrasound examination of the heart.

    This type of diagnosis helps a specialist determine the thickness of the ventricular wall and other myocardial parameters. In addition, echocardiography is able to accurately determine the pressure in the ventricle, which, in turn, makes it possible to diagnose the disease.

  • Examination of the heart using a cardiovisor.
  • Determination of unfavorable hereditary disposition to the disease.

    Those who smoke, regularly consume alcoholic beverages, do not monitor the intensity of physical activity, it is necessary to periodically check with a doctor.

    With HPV, pathological changes are recorded not only in the myocardium. Over time, they are characterized by the spread to the pulmonary arteries and blood vessels, which causes the development of other ailments:

    • aortic sclerosis;
    • hypertension of the pulmonary circulation;
    • Eisenmenger syndrome (excess pressure in the pulmonary artery over the aortic).

    Timely diagnosis of prostate cancer can not only prevent the development of these pathologies, but also greatly facilitate the fight against the syndrome as a whole. Confirm or deny the presence of right ventricular hypertrophy is possible only thanks to apparatus cardiological studies:

    • electrocardiography;
    • echocardiography (ultrasound examination of the structure of the heart muscle).

    The electrocardiogram as a method for the diagnosis of HPV is less indicative. Hypertrophy of the right ventricle on an ECG is expressed only in a change in the teeth of the cardiogram, which can only indicate the fact that the size of the ventricle changes, the severity of the pathology cannot be determined in this way.

    Echocardiography as a method for the diagnosis of HPV is often combined with dopplerography, which allows an additional study of the direction and speed of blood flows. This method of research makes it possible to determine right ventricular hypertrophy even in a moderate form of the course, so that the progression of the growth of cardiomyocytes in the heart muscle can be prevented.

    ECG is a universal, widely available and very popular method. But the diagnosis of right ventricular hypertrophy only through a cardiogram has some drawbacks. First of all, a pronounced hypertrophy is visible on the cardiogram; with slight hypertrophy, changes in the ECG will be insignificant or not at all.

    In addition, to refrain from diagnosing right ventricular hypertrophy by ECG should, if such conditions occur:

    • blockade of the right bundle branch block,
    • WPW syndrome
    • confirmed posterior myocardial infarction,
    • in children, the above ECG signs may be a variant of the norm,
    • transition zone shift to the right,
    • the R wave has a high amplitude in V1 V2, but the R / S ratio in V5 or V6 is greater than unity,
    • dextroposition (the heart is mirrored in the right half of the chest),
    • hypertrophic cardiomyopathy: the presence of high R waves in V1 is possible, with an R / S ratio greater than one.

    When diagnosing right ventricular hypertrophy, the width of the QRS complex should be less than 0,12 s. Therefore, accurate ECG diagnosis is not possible with BPNPG, Wolf Parkinson-White syndrome.

    The main goal of treatment is to bring the size of the heart to normal to normal sizes. The following stages of treatment are provided, aimed primarily at eliminating the cause of hypertrophy:

    • drug treatment (elimination of stenosis, normalization of the lungs, treatment of heart defects);
    • adjustment of nutrition and lifestyle of the patient.

    The therapy is carried out under the regular supervision of a specialist. During treatment, the work of the heart, the frequency of its contraction are systematically checked. In the absence of positive dynamics in treatment, the patient is recommended surgical intervention.

    In the case of the progression of hypertrophy and the development of heart disease, surgery is prescribed. The operation involves the implantation of an artificial valve. The operation is also performed during the first year of life for children who are diagnosed with hypertrophy.

    Only after a diagnosis is made, the doctor can determine the tactics for treating ventricular hyperfunction. Therapy is aimed at eliminating the disease that provoked hypertrophy. There are such methods of treating pathology:

    1. Etiotropic: used for congenital heart abnormalities. Treatment according to this technique is aimed at weakening the factor that provokes hypertrophy.
    2. Pathogenetic: it is used if hypertrophy of the right ventricle is acquired. It is aimed at enhancing the immune system, due to which the factor provoking the underlying disease is neutralized.

    With congenital heart defects, the patient is shown a cardiosurgical operation in the first year of life – replacing the abnormal valve with a full synthetic analogue. If the cause of the change in the parameters of the ventricle is lung disease, then the patient is prescribed:

    • bronchodilators (Broncholitin): eliminate bronchospasm;
    • mukaltic drugs (Bromhexine): dilute sputum and contribute to its exit from the lungs;
    • analeptics: stimulate the functioning of the respiratory system and circulatory system.

    With minor hypertrophy, the doctor prescribes taking Nifedipine, a calcium channel blocker drug. With progressive hyperfunction, drugs of the nitrate group are prescribed:

    All people with right ventricular hypertrophy should be observed by a cardiologist at least once a year and undergo all the tests prescribed by the doctor. These patients are shown a healthy lifestyle: control over body weight, refusal of alcohol and smoking.

    Drug treatment of right ventricular hypertrophy consists in taking the following groups of drugs:

    • Regular intake of diuretics;
    • Beta-blockers (drugs of this pharmacological group are incompatible with alcoholic beverages and smoking);
    • Calcium channel antagonists;
    • Anticoagulants;
    • Magnesium and potassium preparations;
    • The use of cardiac glycosides is permissible in a minimum dosage;
    • Medicines that help lower blood pressure.

    Depending on the cause of the pathology, the following drugs are prescribed:

    • analeptic;
    • broncholitin;
    • bromhexine;
    • aminophylline;
    • nephidipine;
    • nitrosorbitol;
    • nitroglycerine.

    In some cases, it may be necessary to take some of the above medicines throughout life. If positive dynamics or any improvement is not noted, the patient may be prescribed surgery. Therapy is recommended to be carried out under the systematic supervision of a medical specialist.

    Patients should be aware of the dangers of self-medication and not try to pick up drugs on their own. It is recommended that people suffering from overweight, as well as systematically subjected to physical exertion, be regularly examined by a cardiologist.

    Quite often, the treatment of this disease combines drug therapy with folk remedies. It is worth considering that traditional medicine plays the role of auxiliary therapy, it should be used only in combination with the main treatment.

    Take this medicine one tablespoon three times a day thirty minutes before meals. There are no restrictions on the use of this medicinal mixture, it can be taken all year round. Hypericum infusion has a very good effect in the treatment of right ventricular hypertrophy.

    To prepare it, you will need 100 grams of St. John’s wort herb, which must be poured with two liters of water and boiled for ten minutes in a closed container over low heat. Then leave and let the grass stand for about an hour. After the infusion, strain and add to it two hundred grams of honey, stir and bottle.

    Treatment of right ventricular hypertrophy

    The most common causes of right ventricular hypertrophy are concomitant diseases of the heart and lungs. They can be congenital or acquired. Congenital disorders are called:

    1. Tetradou Fallot. Valvular disease, which is diagnosed in newborns. Another name is “blue baby syndrome”: the baby’s skin becomes bluish during crying.
    2. Pulmonary hypertension. Causes increased pulmonary artery pressure.
    3. An anomaly in the structure of the interventricular septum. It leads to the mixing of the blood of the heart, the body receives insufficient oxygen.
    4. Mitral valve stenosis. It causes a violation of the outflow of blood into the artery due to a decrease in the opening.

    The diseases that cause hypertrophy of the right ventricular myocardium include:

    • fibrosis, emphysema;
    • bronchitis;
    • bronchial asthma;
    • pneumonia;
    • chronic fatigue and stress;
    • weight gain;
    • cardiomyopathy;
    • high blood pressure.

    The first symptoms of the disease are not significant, often the patient does not notice them. When the myocardium grows, signs appear in the form of:

    • dizziness;
    • shortness of breath;
    • loss of consciousness;
    • difficulty breathing;
    • arrhythmias;
    • chest pains;
    • shortness of breath;
    • outflow of legs;
    • cyanosis of the skin;
    • interruptions in the heartbeat.

    This is due to the fact that the heart is not adequately supplied with oxygen, the manifestations are similar to heart failure. The doctor should prescribe a diagnosis on modern devices to determine the final diagnosis:

    1. Electrocardiography implies that heart rhythms are transmitted by sensors and recorded on paper. On an ECG, signs of right ventricular hypertrophy can be correctly deciphered by a general practitioner or cardiologist.
    2. Ultrasound of the heart, or echocardiography, accurately reveals changes in the structure of the departments of the heart. The method helps to detect blood flow disorders, measure the degree of pathology.

    Hypertrophy of the right ventricle of the heart on an ECG is visible if its mass becomes larger than the left. It looks like fluctuations in the peaks of the electrocardiogram. Key features:

    1. The electrical axis is deflected to the right.
    2. Ischemia of the subendocardial layers of the myocardium is observed.
    3. In part V1, violations of the QRS complex are visible. Then it has the appearance of a R wave or QR.
    4. In area V6, the complex has the form RS.
    5. In region V1, there are deviations from the norm in the ST segment. It is located below the contour and has an asymmetric shape.
    • vitamins with magnesium and potassium;
    • blockers that reduce heart rate;
    • diuretics that remove water;
    • anticoagulants;
    • calcium channel antagonists responsible for heart rate;
    • medicines that lower blood pressure;
    • sedatives.

    For prevention, a special diet is prescribed. The patient should exclude foods with a high salt content, add lean meat, fish, fruits, vegetables. Surgical intervention is used only when the result of the increase is already becoming a heart defect. In young children, this operation can be carried out in the first year of life.

    The causes of right ventricular hypertrophy of the heart can be the development of other ailments of the cardiovascular system:

    • aortic valve stenosis is a cardiological disease in which the opening of one of the valves of the heart decreases, slowing the circulation of blood through the heart vessels. It is mainly found of an acquired nature and most often in men. Congenital is quite rare;
    • pulmonary arterial hypertension is a rare, but very serious disease, the cause of which is high blood pressure, causing a serious burden on the heart and can cause a stop on its right side;
    • ventricular septal defect. It is characterized by the presence of a hole in the septum separating the right ventricle from the left, resulting in impaired blood circulation;
    • tetralogy of Fallot – occurs in newborns.

    Normal heart and hypertrophied

    Provocateurs for the growth of cardiomyocytes, which can lead to an accelerated development of the disease, are: emphysema, fibrosis, pneumoconiosis, pneumonia, sarcoidosis, chronic bronchitis and bronchial asthma.

    Medical treatment of the heart is not particularly difficult. Its task is to eliminate the symptoms of pathology by prescribing drugs and pharmacological groups that provide therapeutic intervention. These include: blood pressure stabilizers, diuretics (diuretics), adrenergic blockers, cardiac glycosides and anticoagulants.

    To maintain and stability of the effect, some of the above funds will have to be consumed throughout life. For a full recovery, suffering from hypertrophy, provides for a complete rejection of the abuse of alcohol and tobacco products, as well as adherence to the prescribed diet and diet.

    Patients with hypertrophy are advised to regularly visit medical facilities for a preventive examination of the cardiovascular system.

    First of all, this applies to patients with congenital pathology, athletes who are engaged in cardiac training, people who have had bronchial diseases, as well as those who have recently undergone a full course of rehabilitation.

    Prevention

    It is recommended to lead a healthy life, the load on the body should be moderate, oxygen cocktails are also a good preventive measure.

    IB4. Tetrad Fallo

    Right ventricular hypertrophy is much less common than left ventricular.

    Hypertrophy is caused by an increase in the size of the heart due to an increase in the size of the cells of the heart tissue. In this case, only cardiomyocytes undergo growth.

    The causes of right ventricular hypertrophy are:

    • Narrowing or stenosis of the pulmonary valve located at the exit from the right ventricle of the pulmonary artery;
    • Increased blood pressure in the pulmonary artery (pulmonary hypertension). As a rule, this condition is accompanied by dizziness, fainting, shortness of breath;
    • Tetrad Fallot. This is a congenital heart disease, which is characterized by four signs: pulmonary valve stenosis, right ventricular hypertrophy, aortic displacement to the right side, and interventricular septal defect. This defect is also called the “blue” defect, since its main symptom is the turning blue of various parts of the body;
    • Ventricular septal defect. With this defect, two departments of the heart communicate with each other, as a result, blood mixes, which leads to insufficient oxygen supply to the organs. The heart tries to compensate for the lack of nutrition of organs by increasing the contractions of the ventricles, which leads to an increase in both ventricles;
    • Pulmonary diseases (chronic bronchitis, chronic pneumonia, pneumosclerosis, pulmonary emphysema).

    Physiological hypertrophy is promoted by systematic aerobic exercises. Therefore, an increase in heart size is often observed in people who play sports and lead an active lifestyle.

    In the early stages of right ventricular hypertrophy, its symptoms are not pronounced.

    At later stages, signs of right ventricular hypertrophy are manifested:

    • A feeling of heaviness and severe pain in the chest;
    • Difficulty breathing;
    • Arrhythmia, impaired heartbeat. Quite often, patients feel a sense of “trembling” of the heart in the chest;
    • Sudden bouts of dizziness. Fainting conditions;
    • Severe swelling on the legs.

    The clinical picture of right ventricular hypertrophy may also be accompanied by a “pulmonary heart”, the cause of which is pulmonary embolism. Acute pulmonary heart is characterized by acute right ventricular failure, severe shortness of breath, decreased blood pressure, and tachycardia.

    The chronic form of the pulmonary heart has the same clinical picture as the acute pulmonary heart until the decompensation process begins. In severe forms of chronic right ventricular failure, chronic obstructive pulmonary disease occurs.

    The goal of treatment is to normalize pulmonary function, treat heart defects and eliminate narrowing of the pulmonary valve. The composition of drug therapy also includes drugs that slow down the development of hypertrophy.

    Much attention is paid to symptomatic treatment, the task of which is additional nutrition and maintenance of the heart muscle, normalization of blood pressure and heart rate.

    If the cause of right ventricular hypertrophy is a heart defect, then the patient is shown surgical treatment (most often in childhood).

    Patients with right ventricular hypertrophy must follow a special diet, adhere to the correct daily regimen, and stop smoking and alcohol. Especially effective in this condition are aerobics, swimming, physiotherapy exercises, running.

    Thus, right ventricular hypertrophy is a rather rare, nevertheless, occurring condition, especially in people prone to bad habits, obesity, and athletes involved in power sports. Therefore, it is especially important for these categories of people to monitor their heart condition in order to prevent the development of right ventricular hypertrophy and, as a result, serious heart diseases.

    The main external signs of right ventricular hypertrophy include difficulty breathing in combination with heaviness and chest pain, sudden bouts of dizziness with loss of consciousness, heart rhythm disturbances with a sensation of “missed” strokes, and severe swelling of the legs.

    You can suspect an ailment with the help of an electrocardiogram. This diagnostic method does not indicate the true size of the right ventricle, but signals changes in electrical conductivity, which in turn can be associated with violations of the size of the ventricle. Echocardiography or ultrasound of the heart will help to see a detailed picture. This method allows you to visually assess the size of the heart and its departments, as well as to assess the pressure inside the chambers of the heart.

    Treatment of right ventricular hypertrophy is usually symptomatic. On the one hand, it is aimed at eliminating the underlying disease, and on the other, at maintaining the normal functioning of the lungs and heart muscle.

    Features of the disease in children

    A change in size indicates an abnormal growth of heart cells (cardiomyocytes). The difference between a hypertrophied myocardium is that the vessels cannot nourish an overgrown organ.

    For this reason, part of it experiences ischemia – a lack of oxygen and nutrients. Dilation of the right ventricle is one of the varieties of the disease.

    An increase in the right ventricle of the heart is observed more in childhood. In infants, immediately after birth, the load on the right side of the heart is greater than on the left. Doctors call this cause of the change in the organ physiological.

    However, congenital hypertrophy of the right ventricle in children is much more common. Some symptoms of the disease do not appear immediately.

    Constant monitoring of the condition of the baby, a full examination after birth help to make the correct diagnosis and choose the exact treatment methods.

    Physiological hypertrophy of the right departments can occur in the first days of life of the crumbs, since during this period there is a sharp restructuring of the circulatory system. However, more often the causes of this pathological condition in infants are as follows:

    • heart septal defect;
    • violation of the outflow of blood from the cavity of the right ventricle;
    • increased load on these parts of the heart during fetal development;
    • pulmonary stenosis.

    In this case, the symptoms of the disease may not appear immediately, but after some time. This is due to the fact that at first, heart dysfunction is compensated by various protective mechanisms. With the development of a decompensated state, the first signs appear, but the condition of the child can be quite serious.

    Physiological hypertrophy occurs in children of the first days of life, pathological – in various congenital heart defects (transposition of the great vessels, Fallot tetrad, ventricular septal defect and open arterial duct with high pulmonary hypertension, etc.), primary pulmonary hypertension, and congenital lung and lung diseases blood vessels (Wilson-Mikiti syndrome, lobar emphysema, etc.), chronic carditis, etc.

    Finally, children often experience acute overloads of the right ventricle in case of a burn disease, acute pneumonia, and other conditions, often imitating right ventricular myocardial hypertrophy. Diagnosis of right ventricular hypertrophy by ECG in some cases is fraught with difficulties.

    Significant difficulties are caused by the identification of signs of right ventricular hypertrophy on the ECG with vivid symptoms of left ventricular myocardial hypertrophy. Electrocardiographic changes in right ventricular hypertrophy are associated with the fact that the EMF vector of the right ventricle becomes predominant and changes the orientation of the total EMF to the right and forward with the excess of its normal age potentials.

    At the same time, right ventricular hypertrophy is judged by the deviation of the EMF vector forward (leads V3R, V1, V2) and to the right (leads from the limbs). The combination of these signs makes the diagnosis most likely.

    • the appearance of severe and sudden pain in the sternum;
    • a sharp decrease in pressure (up to the development of signs of a collapse state);
    • swelling of the neck veins;
    • progressive increase in liver size (pain in the right hypochondrium joins this process);
    • sharp psychomotor agitation;
    • the appearance of a sharp and pathological pulsation.

    A sharp shortness of breath develops at rest, a person feels tightness in the chest. Later, suffocation, cyanosis occurs, to which the cough joins. Sudden death may occur in one third of all cases of pulmonary embolism.

    With compensated pulmonary heart, as the main consequence of right ventricular hypertrophy, the symptoms of the underlying disturbance are not pronounced. Some patients may notice the appearance of a slightly pronounced pulsation in the upper abdomen.

    Other symptoms indicate that a person develops so-called congestive heart failure.

    An increase in the right ventricle of the heart is observed more in childhood. In infants, immediately after birth, the load on the right side of the heart is greater than on the left. Doctors call this cause of the change in the organ physiological. However, congenital hypertrophy of the right ventricle in children is much more common. Some symptoms of the disease do not appear immediately. Constant monitoring of the condition of the baby, a full examination after birth help to make the correct diagnosis and choose the exact treatment methods.

    Hypertrophy in newborns

    Most often, this syndrome occurs in newborns as a result of problems with the development and functionality of the heart. This condition develops in the first days of life, when the load on this organ is especially great (especially on its right half.

    Hypertrophy of the right ventricle of the heart also develops with a defect in the septum that divides the ventricles. In this case, the blood mixes, it becomes insufficiently saturated with oxygen. The heart, trying to restore normal blood flow, increases the load on the right ventricle.

    Hypertrophy is also possible due to tetralogy of Fallot, narrowing of the pulmonary valve. If any symptoms are found that indicate a malfunctioning heart, you should immediately show the child to a specialist.

    Symptoms of HPV

    In the acquired form, this syndrome is characterized by the absence of specific symptoms by which it is possible to determine just right ventricular hypertrophy.

    Signs of right ventricular hypertrophy are similar to the manifestations of many other ailments and at the initial stage of the development of pathology practically do not manifest themselves, starting to really disturb the patient only with a significant increase in the size and weight of the right ventricular myocardium. These signs include:

    • prolonged pain in the right sternum of a sharp, stitching character;
    • dyspnea;
    • dizziness, accompanied by a loss of orientation in space and fainting (in some cases);
    • violation of the rhythm of the heart;
    • swelling of the lower extremities, which becomes more pronounced by the end of the day.

    The main clinical signs of HPV include an increase in the frequency of heart contractions (tachycardia) and a sharp decrease in blood pressure. The clinical picture of right ventricular hypertrophy may also be accompanied by a “pulmonary heart”, the cause of which is pulmonary embolism.

    The principle of electrocardiography

    As for the features of electrocardiography in diseases of the cardiovascular system, there are a lot of them. First you need to focus on the fact that such an examination is carried out in the most comfortable position for the patient.

    It’s important to know! During the examination, the patient should be in a relaxed state and breathe calmly, evenly, as the result of electrocardiography depends on this. To determine the ECG signs of right ventricular hypertrophy, 12 leads are used, 6 pieces are connected to the chest, and the remaining 6 pieces are connected to the patient’s limbs.

    Sometimes the technique of conducting electrocardiography at home is used, in this case only 6 branches are used. When conducting such a diagnosis, it is important to understand that several factors influence its outcome:

    1. The condition of the patient.
    2. The correct breathing of the patient.
    3. The number of leads used.
    4. Correct connection of each branch.

    Even if one electrode is not connected correctly, the electrocardiogram information may be false or incomplete. When conducting such an examination, the main emphasis is on the heart rhythm, the features of the T and ST teeth, the intervals of cardiac conduction, the electrical axis of the heart and the characteristics of the QRS.

    Prevention

    Prevention of right ventricular hypertrophy comes down to the following several requirements. Firstly, this is a warning of the development of phlebothrombosis of the legs:

    • diagnosis of this pathology at the earliest stages and its immediate treatment;
    • preventive examination by a specialist;
    • after surgery, with the diagnosis of phlebothrombosis, the patient is recommended active movement;
    • fulfillment of all doctor’s recommendations.

    In case of chronic lung diseases:

    • Avoid hypothermia and draft;
    • do not smoke, including not being a member of second-hand smoke;
    • treat the disease at the earliest stages;
    • lead an active lifestyle with an adequately moderate load;
    • take oxygen shakes.

    For prevention purposes, it is also recommended to periodically do an electrocardiogram, abandon bad habits and adhere to therapeutic nutrition. You should regularly check with a cardiologist, undergo examinations, follow all recommendations and take appropriate medications.

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  • Svetlana Borszavich

    General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
    Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
    The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
    The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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