Symptoms of right ventricular hypertrophy

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Causes

The reasons for the development of left ventricular hypertrophy (LVH) have a fairly wide range and depend on the following factors:

  • age of the patient;
  • heredity;
  • Lifestyle;
  • the presence of bad habits;
  • condition of the vascular system.

At a young age, the main cause of left ventricular myocardial hypertrophy is regular physical activity (playing sports, hard work), while for the elderly, the main cause is atherosclerotic lesion of the vascular system. In all cases, there is an increase in the thickness of the myocardium (heart muscle) designed to compensate for the increased need for oxygen (during sports) or with complicated hemodynamics (with arteriosclerosis).

In contrast to the left, hypertrophy of the right ventricle (PCG) develops due to a malfunction of the valve system:

  • congenital heart disease (usually found in children);
  • mitral valve stenosis;
  • lung diseases.

In the figure: on the left is a healthy heart, on the right is left ventricular myocardial hypertrophy (an increase in myocardial thickness and a decrease in the ventricular cavity are visible)

1. Pulmonary heart

Due to the fact that the main load for the right ventricle is created by the respiratory organs, or rather, vessels localized in the lung tissue, hypertrophy can develop with lung pathology.

The main diseases that can cause pulmonary heart disease are as follows:

  • Bronchial asthma, especially long-lasting, with prolonged exacerbations, proceeding with severe, poorly treatable seizures. Often, hormone dependence in bronchial asthma leads to the formation of a pulmonary heart.
  • COPD (chronic obstructive pulmonary disease), with frequent exacerbations of chronic obstructive bronchitis. It develops more often among smokers and people with occupational hazards, sandblasters, gas industry workers, etc.).
  • BEB (bronchiectatic disease), with frequent inflammatory processes in altered areas of the lung tissue – in bronchiectasis.
  • Cystic fibrosis is a disease that affects the digestive system (lack of pancreatic enzymes), as well as respiratory organs with frequent purulent bronchitis and pneumonia due to impaired discharge of thick, viscous mucus in the lumen of the bronchi and alveoli.
  • Frequent, recurrent pneumonia.

development of pancreatic hypertrophy in pulmonary hypertension

pancreatic hypertrophy with congenital malformation – tetralogy of Fallot

In the case of other heart defects, for example, pulmonary stenosis or tricuspid valve insufficiency, hypertrophy develops more slowly, and decompensation of heart failure can occur within a few months or years. The mechanism of development of right ventricular hypertrophy with these defects is caused by overload of the right ventricle with pressure (when the ventricle is hard to push the right amount of blood into the narrowed lumen of the pulmonary trunk) or volume (with tricuspid valve insufficiency, part of the blood is thrown back into the cavity of the right atrium with each contraction, and with each subsequent contraction into the right ventricle pushes a much larger volume of blood).

pancreatic hypertrophy with pulmonary stenosis

A mechanism similar to the latter for the development of hypertrophy is also formed with defects in the atrial or interventricular septa.

Most often, pancreatic hypertrophy develops with insufficiency of the tricuspid valve (described in the previous paragraph) or stenosis of the left atrioventricular opening (mitral valve). In the latter case, pancreatic hypertrophy develops a second time, since the left atrium hypertrophies first, and only then, due to stagnation of blood in the vessels of the lungs, the wall thickness of the right ventricle increases.

Everyone knows what the heart is. However, in order to get a complete picture of how cardiac activity is reflected in an electrocardiogram, it is important to have information about its anatomical structure and functions.

The main structural elements of the heart are 4 chambers (cavities):

  • atria (left and right);
  • ventricles (left and right).

Due to the fact that blood flow should occur in one direction, regulation is carried out using 4 valves that allow or block the movement of blood flow:

    mitral – a bicusp >

Structure of the human heart

Even less frequently, an electrocardiogram shows an increase in two heart chambers simultaneously. Often, an increase in the pancreas is not visible due to the fact that signs of left ventricular hypertrophy overlap it. There may be the following ECG signs:

  1. A combination of LVH signs with a simultaneous deviation of the electrical axis of the heart to the right.
  2. A combination of signs of an increase in the pancreas and a deviation of the electrical axis of the heart to the left.
  3. The high R wave in V5, V6, as well as the high R wave over 7 mm in V1, V2.
  4. If there are signs of an increase in the pancreas, there is no S wave in V5-6.
  5. The combination of left ventricular hypertrophy with incomplete blockade of the right bundle branch block.

Today, there is a great opportunity to make a diagnosis using echocardiography, which does not violate the integrity of the body. It is only necessary to install the sensor on the surface of the patient’s chest to obtain information about the state of his cardiovascular system. Therefore, in obscure cases, the latter method is indispensable in making the correct diagnosis.

RV hypertrophy is not always manifested by any symptoms, therefore, in the initial stages, in the case of moderate hypertrophy, it can only be recognized with the help of an additional examination. Most often, the patient has signs of the underlying disease, for example, attacks of bronchial asthma or a pneumonia clinic.

  1. Dry cough, sometimes with hemoptysis,
  2. Decreased tolerance to normal physical activity due to paroxysmal shortness of breath,
  3. Fatigue, decreased performance,
  4. The feeling of a rapid heartbeat and interruptions in the work of the heart, often due to cardiac arrhythmias (extrasystole. Atrial fibrillation),
  5. Pain in the region of the heart according to the type of angina pectoris (pressing chest pain, burning in the heart) associated with oxygen starvation of cells of the enlarged heart muscle, which provokes right ventricular ischemia.

With the progression of cardiac right ventricular failure, the patient has clinical signs of stagnation of blood over a large circle of blood circulation – swelling of the legs and feet, sometimes taking a pronounced character, up to the spread of edema throughout the body (anasarca); pain in the right hypochondrium due to the fact that blood stagnates in the liver, overstretching its capsule;

Unfortunately, hypertrophy of the right ventricle in the initial stages is almost impossible to recognize clinically and by electrocardiogram. However, there are a number of ECG criteria according to which hypertrophy can be suspected in patients with existing causal diseases.

Depending on how much the right ventricle is enlarged compared to the left, there are three forms of right ventricular hypertrophy on an ECG:

  • The right ventricle is hypertrophied, but much smaller in size than the left (moderate hypertrophy);
  • The right ventricle is hypertrophied, but does not exceed the mass of the left ventricle;
  • The right ventricle far exceeds the mass of the left (severe hypertrophy).

Despite the fact that using ECG it is possible to determine only severe pancreatic hypertrophy, there is another very informative diagnostic method. allowing you to visually assess the wall thickness, mass and volume of the right ventricle. This method is an ultrasound of the heart, or echo-cardioscopy. Ultrasound of the heart can reliably determine pancreatic hypertrophy in the early stages.

In addition to ECG and ultrasound, a patient with a suspected pancreatic hypertrophy is required to conduct a chest x-ray, which can give information on how enlarged the heart is, and especially its right side.

An electrocardiogram is a graphical representation of the changes in electric fields that occur during heart function. The contractile activity of the heart is initially regulated by an electrical impulse generated by a sinotral (sinus) node located at the apex of the right atrium. The impulse quickly spreads through the muscle layer of the atria in the direction from top to bottom and left.

Having reached the atrioventricular junction, the impulse significantly reduces the speed and, now, in the opposite direction (from left to right), that is, it first covers the left ventricle, and then the right one. All stages of the heart are reflected on the cardiogram in the form of teeth. Normally, 5 teeth are distinguished on the ECG: P, Q, R, S, T.

Table: Correspondence of the signs adopted in the ECG, the duration of the phases of the heart

Hypertrophy of the right ventricle: what are it, causes, symptoms, diagnosis, treatment

According to statistics, right ventricular hypertrophy is much less common than left ventricular hypertrophy.Normally, the weight of the left ventricle is about 3 times less than the mass of the left ventricle, and even with a slight increase in the right ventricle, its weight still remains smaller compared to the left ventricle.

The following causes affect the enlargement of the right ventricle mainly:

  • High blood pressure in the pulmonary artery, also called pulmonary hypertension. This condition is usually accompanied by fainting, dizziness, shortness of breath at rest.
  • Stenosis (narrowing) of the pulmonary valve, which is located at the exit of the pulmonary artery from the right ventricle.
  • A defect (malformation) of the interventricular septum, in which blood is mixed between the right and left half of the heart. In this case, the blood entering the organs and tissues does not contain the norm of dissolved oxygen, and therefore the heart is forced to compensate for this by increasing the contractions of the ventricles. At the same time, both ventricles increase in size.
  • Tetralogy of Fallot, in which there are 4 deviations from the norm – hypertrophy of the right ventricle, stenosis of the pulmonary valve, defect of the interventricular septum and a shift to the right of the aorta. This defect is also called the “blue” defect, since the main symptom is the turning blue of many parts of the face and body.
  • Various lung diseases (chronic pneumonia, chronic bronchitis, pulmonary emphysema, pneumosclerosis).

This disease can not be called typical. It is not common, and it is sometimes difficult to recognize it. What are the causes of this disease? There are two main causes of right ventricular hypertrophy. It:

  • Mitral stenosis, which is characterized by a decrease in the area of ​​the hole that connects the right atrium and the same ventricle. This hole closes the mitral valve.
  • Pathology of the heart, formed in the womb.

That is, right ventricular hypertrophy develops on the basis of all kinds of abnormalities in the structure of the heart, often acquired even at the stage of fetal formation, in children, and in adults, any lung disease with complications that affected the heart muscle or valve can become the soil for the development of the disease heart disease.

  • Tetrad Fallot. This pathology manifests itself already with the birth of a child. Her symptoms may accompany the peanut throughout the first year of life. Manifestations of this disease are also called “blue baby syndrome” – which is a manifestation of blood outflow dysfunction.
  • Hypertension of pulmonary genesis. It is caused by an increase in pressure in the small pulmonary circle of the artery. In this regard, the patient acquires shortness of breath, dizziness in combination with fainting conditions.
  • Valve stenosis of the small circulation ring. A manifestation of this pathology is a violation in the work of the outflow of blood plasma into the blood vessel from the valve.
  • Pathology of the interventricular septum. The defective structure of the cardiac septum allows two streams of neighboring departments to mix. This leads to a decrease in the amount of oxygen transported, as well as an increase in the load on all areas of the heart, including the right ventricle.

Among the pulmonary pathologies that can cause hypertrophy of the right ventricle, we can highlight:

  • Pneumonia or pneumonia.
  • Fibrosis. On the contrary, the compaction of the lung tissue formed as a result of the transferred inflammatory process, or for any other reason.
  • Bronchial asthma.
  • Emphysema. This is a pathological expansion of the alveoli (pulmonary sacs) and the airways in contact with them.
  • Chronical bronchitis.
  • Pneumosclerosis The proliferation of lung tissue, which may be a consequence of the same inflammatory process.

A cause of an increase in the size of the right ventricle may be a congenital defect or mitral stenosis of the heart. Most often, right ventricular hypertrophy is observed:

  • In children, against the background of various congenital heart defects;
  • In adults, against the background of valvular heart diseases and lung diseases, which are complicated by disorders of the heart.

Depending on the severity of the disease and the characteristics of its development, various configurations of the disease can be observed. Among the main causes of right ventricular hypertrophy are:

  • Pulmonary hypertension, which causes an increase in pressure in the pulmonary artery. This causes shortness of breath, dizziness, and fainting;
  • Tetralogy of Fallot, which is observed in children from birth and can continue throughout the first year of a child’s life. This congenital heart disease that causes the blue baby syndrome is characterized by impaired outflow of blood from the right ventricle;
  • Pulmonary valve stenosis, in which there is a violation of blood flow from the right ventricle to the artery;
  • A defect in the interventricular septum, due to which there is a mixing of the blood of the two departments. This causes a lack of oxygen, which leads to increased work of all parts of the heart, including the right ventricle.
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Among the lung diseases that can lead to the development of this pathology, there are:

  • Fibrosis and emphysema;
  • Chronic bronchitis and pneumonia;
  • Pneumosclerosis;
  • Bronchial asthma.

Right ventricular hypertrophy (HRG) is a serious pathology characterized by an increase in the size and mass of the right ventricle, which occurs due to a change in the number of cardiomyocytes (muscle cells of the heart). In a normal state, cardiomyocytes make up a quarter of the total number of cardiac cells, with hypertrophy their number increases. This pathology occurs as a syndrome that has developed against the background of other diseases of the cardiovascular system:

  • aortic valve stenosis (congenital or acquired);
  • tetralogy of Fallot (the most commonly diagnosed form of heart disease in newborns);
  • pulmonary arterial hypertension;
  • structural defects of the interventricular septa.

Catalysts for the growth of cardiomyocytes, which leads to the progression of pathology, can be different bronchopulmonary ailments:

  • fibrosis;
  • emphysema;
  • chronic obstructive bronchitis;
  • bronchial asthma;
  • pneumoconiosis;
  • sarcoidosis;
  • pneumonia.

There are also causes of right ventricular hypertrophy that are not associated with cardiovascular or pulmonary diseases:

  • pathological increase in body weight (obesity);
  • systematic and prolonged stress flowing into neurosis.

Another factor provoking the development of right ventricular hypertrophy may be excessive enthusiasm for aerobic exercise.

Depending on the ratio of sizes and weight of the right and left ventricles, there are three forms of the course of HPV syndrome: moderate, medium and sharp (acute). In the moderate form of HPV, the size of the right ventricle slightly prevails in size over the left one, their weight is almost the same. note the excess size and mass of both ventricles, with a pronounced form, the difference in these parameters is significant.

  • physiological (congenital), when the right ventricular hypertrophy in a child is diagnosed from the first days of life. Pathology manifests itself as a consequence of CHD (congenital heart defects) and is often diagnosed immediately after birth by extensive cyanosis (cyanotic shade of the skin) of the face or entire body.
  • pathological (acquired) – a syndrome of enlargement of the right ventricle occurs as a result of transferred bronchopulmonary ailments or physical overloads.
  • Tetradou Fallot. Valvular disease, which is diagnosed in newborns. Another name is “blue baby syndrome”: the baby’s skin becomes bluish during crying.
  • Pulmonary hypertension. Causes increased pulmonary artery pressure.
  • 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.
  • 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.

    1. Pulmonary heart

    • Bronchial asthma, especially long-lasting, with prolonged exacerbations, proceeding with severe, poorly treatable seizures. Often, hormone dependence in bronchial asthma leads to the formation of a pulmonary heart.
    • COPD (chronic obstructive pulmonary disease), with frequent exacerbations of chronic obstructive bronchitis. It develops more often among smokers and people with occupational hazards, sandblasters, gas industry workers, etc.).
    • BEB (bronchiectatic disease), with frequent inflammatory processes in altered areas of the lung tissue – in bronchiectasis.
    • Cystic fibrosis is a disease that affects the digestive system (lack of pancreatic enzymes), as well as respiratory organs with frequent purulent bronchitis and pneumonia due to impaired discharge of thick, viscous mucus in the lumen of the bronchi and alveoli.
    • Frequent, recurrent pneumonia.

    pancreatic hypertrophy with congenital malformation – tetralogy of Fallot

    In the case of other heart defects, for example, pulmonary stenosis or tricuspid valve insufficiency, hypertrophy develops more slowly, and decompensation of heart failure can occur within a few months or years.

    The mechanism of development of right ventricular hypertrophy with these defects is caused by overload of the right ventricle with pressure (when the ventricle is hard to push the right amount of blood into the narrowed lumen of the pulmonary trunk) or volume (with tricuspid valve insufficiency, part of the blood is thrown back into the cavity of the right atrium with each contraction, and with each subsequent contraction into the right ventricle pushes a much larger volume of blood).

    Causes

    Manifestations of hypertrophy

    GVH at the initial stage has a rather blurred symptomatic picture, and in some cases the symptoms are not recognized at all. However, with a pronounced manifestation of the pathology, the following picture can be observed:

    • patients complain of pain and compression in the chest, while breathing is difficult;
    • coordination of movements is disturbed, there are attacks of dizziness, leading to a temporary loss of consciousness;
    • there is a violation of the heart rhythm, patients note “squabbles” and interruptions in the work of the heart, as if some beats are missed;
    • severe shortness of breath even in a calm state;
    • swelling in the lower extremities, which in the evening becomes more pronounced;
    • stable loss of strength and apathy;
    • severe insomnia or drowsiness.

    In children, this condition is sometimes regarded as a natural manifestation of physiology against the background of an increased load on the right half of the heart. But more often, such a deviation becomes the result of congenital malformations of the heart and is diagnosed in newborns. Such a child has a pronounced cyanosis of the skin.

    HPV and LVH may precede the development of serious cardiological diseases associated with an increase in heart muscle. For this pathology, it is characteristic that the striated heart tissue grows, but the internal dimensions of the ventricles remain unchanged. This is a serious deviation from the norm and leaving the problem without attention is unacceptable. To exclude further adverse development of events, you should urgently seek medical help.

    Hypertrophy of the right ventricle: what are it, causes, symptoms, diagnosis, treatment

    With the syndrome of right ventricular hypertrophy, the symptoms in the early stages are not pronounced, but in the later stages of the disease, the symptoms appear in the following:

    • Patients feel severe chest pain, a feeling of heaviness, difficulty breathing.
    • Arrhythmia or palpitations (tachycardia) are disturbing. Often, patients note a feeling of “fluttering” of the heart in the chest.
    • Fainting, sudden bouts of dizziness.
    • Severe swelling on the legs.

    The clinic of right ventricular hypertrophy is also called a “pulmonary heart”, which can be acute and chronic. The main cause of acute pulmonary heart disease is pulmonary embolism, which can be multiple or massive. For the clinic of an acute pulmonary heart, the characteristic symptoms are acute right ventricular failure, shortness of breath, tachycardia, and a decrease in blood pressure. In most cases, the acute form of right ventricular failure results in the death of patients.

    The chronic form of the pulmonary heart does not differ from the acute picture of the disease until the decompensation process begins. Severe cases of chronic right ventricular failure end with a clinical picture of chronic obstructive pulmonary disease.

    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 mass of the right ventricular myocardium.

    • 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 classification of pathology is based on the characteristics of the clinical course of the disease.

  • Pronounced – in this situation, the mass of the right ventricle greatly exceeds this parameter for an element starting a large circle of blood circulation.
  • Classical – characterized by an increase in the size of the right ventricle, however, its mass is inferior to a similar parameter on the left side. Excitation in this zone has a longer duration.
  • Moderate – accompanied by a slight external increase in the right ventricle, but its weight is less when compared with the left.
  • Emphysema. This term refers to the pathological expansion of the alveoli and the nearby respiratory tract.
  • Mitral stenosis. In such a situation, the opening narrows, which prevents the removal of blood from the atrium.

    Depending on the size ratio and the mass of the right and left ventricles, three forms of the course of HPV syndrome are distinguished: moderate, medium and sharp (acute).

    With a moderate form of HPV, the size of the right ventricle slightly prevails in size over the left, their weight is almost the same.

    With an average form of HPV, an excess of size and mass of both ventricles is noted, with a pronounced form, the difference in these parameters is significant.

    The absence of therapeutic measures in the acute form of the course of pancreatic hypertrophy can lead to the death of the patient.

    Also, the syndrome of HPV is classified by the type of occurrence:

    • physiological (congenital), when the right ventricular hypertrophy in a child is diagnosed from the first days of life. Pathology manifests itself as a consequence of CHD (congenital heart defects) and is often diagnosed immediately after birth by extensive cyanosis (cyanotic shade of the skin) of the face or entire body.
    • pathological (acquired) – a syndrome of enlargement of the right ventricle occurs as a result of transferred bronchopulmonary ailments or physical overloads.

    Symptoms of HPV

    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.

    Methods of diagnosis

    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.

    The syndrome of HPV on electrocardiography is “illuminated” only in the middle and acute forms of the course.

    An echocardiogram has much greater diagnostic value.

    This research method allows you to determine not only the presence of an increase in the right gastric region, but also its exact size, as well as diagnose defects in the structure of heart tissues.

    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.

    The goal of the treatment of right ventricular hypertrophy is to stabilize the size of the affected section and prevent further growth of cardiomyocytes. The main methods of treating pathology are surgical intervention and drug therapy.

    Surgery involves resection of overgrown vessels and the installation of special prostheses instead of damaged heart valves.

    The drug treatment of prostate cancer consists in eliminating the symptoms of pathology by taking medications from various pharmacological groups:

    • anticoagulants;
    • diuretics;
    • cardiac glycosides;
    • blood pressure normalizers;
    • beta – blockers.

    To maintain a positive effect, some of the prescribed drugs should be taken throughout life. Combined therapy for right ventricular hypertrophy also includes a complete rejection of bad habits, correction of the daily regimen and nutrition.

    Prevention of HPV primarily consists in regular and timely diagnosis of the state of the heart muscle. This is especially true for patients from the risk group, which includes people with congenital pathologies of the cardiovascular system and those who have recently had various bronchopulmonary diseases, as well as athletes who are fond of cardiotraining.

    An increase in blood pressure is considered the basis for the development of HPV. At high blood pressure, blood enters the chambers of the heart with great force. The main blow of the abnormal throw-up is taken by the right ventricle. Under the influence of adverse factors, vasoconstriction occurs, resistance increases. This condition is compensated by the heart for hard work, increasing the frequency of contractions. In this mode, the organ cannot function normally for a long time. As a result, muscle building occurs.

    A change in the size of the heart muscle is accompanied by a significant increase in the number of cardiomyocytes (cardiac cells). Their numerical growth never occurs “out of the blue”.

    Hypertrophy is considered a consequence of cardiac or pulmonary pathology.

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    The following types are distinguished:

    • moderate – noncritical increase in the right ventricle;
    • classic – an increase in the right ventricle, but its mass is less than the left;
    • pronounced – the weight of the right ventricle significantly exceeds.

    The congenital form can be diagnosed in the fetus in the womb. Acquired hypertrophy is a sign of other pathologies.

    Causes of

    Right ventricular myocardial hypertrophy can hardly be called a typical, independent disease. A number of adverse factors can provoke a change in the heart muscle. But the main reasons are considered concomitant or congenital pathologies of the heart, lungs. Cardiological reasons include:

    1. Valvular disease Tetrada Fallot (blue heart disease). It is a congenital heart defect, in which 4 anomalies are simultaneously observed at once: obstruction of the outlet of the right ventricle, defect of the interventricular septum, right ventricular hypertrophy, aortic displacement.
    2. Ventricular septal defect. A change in structure provokes the mixing of two blood flows of neighboring parts of the heart. This process reduces the level of oxygen entering the organ. Oxygen starvation creates an additional burden on the heart.
    3. Mitral valve stenosis. The disease is characterized by a decrease in the opening that connects the right atrium and the right ventricle. As a result, the outflow of blood from the atrium is disrupted.

    Causes

    • obstructive bronchitis;
    • bronchial asthma;
    • pneumosclerosis;
    • emphysema;
    • polycystic;
    • tuberculosis;
    • sarcoidosis;
    • bronchiectatic disease;
    • pneumoconiosis.

    Diagnosis of right ventricular hypertrophy

    Hypertrophy of the right ventricle is a condition in which the wall thickness and mass of this part of the heart increase. In this case, there is a violation of the circulatory process, which is manifested by certain symptoms and impaired functioning of different organs. On the ECG, signs of right ventricular hypertrophy are clearly visible, but only a specialist can correctly identify and decipher the data. Consider the main causes of right ventricular hypertrophy, its signs, possible complications and treatment methods.

    As already mentioned, with this disease, the mass and wall thickness of the right ventricle increases. This phenomenon is an impetus for the development of more dangerous pathologies. Indeed, from this section begins a small circle of blood circulation, which means that the saturation of the body with blood depends on how the ventricle works.

    Hypertrophy of the right ventricle of the heart is a rather rare disease. It occurs mainly in children and in people who abuse alcohol (especially strong), in smokers. Often people with excessive physical exertion also suffer from these diseases. Doctors distinguish between moderate, moderate and severe degree of hypertrophy. All of them differ in the degree of severity of the increase in the size of the ventricle.

    Causes of hypertrophy

    The main reason why a person develops myocardial hypertrophy of the right ventricle is a high load on him. This happens if the blood pressure in the pulmonary circulation remains high for a long time. There may also be a release of blood into the right ventricle in some heart defects. And in this case, hypertrophy often occurs.

    Hypertrophy of the right ventricle in a child often develops as a result of congenital heart defects. In particular, a fairly common reason for the development of this pathology is a defect in the septum between the ventricles. From the left ventricle, blood flows partially into the aorta, and then through this septum into the right ventricle. In this case, it has an increased load. Other heart defects in which signs of hypertrophy are visible on the ECG are as follows:

    • insufficient development of the pulmonary valve;
    • Fallot’s tetrad;
    • other conditions associated with pathologies of the septum.

    The causes of ventricular hypertrophy in adults are:

    • lung diseases such as asthma, chronic bronchitis, tuberculosis;
    • rachiocampsis;
    • polio;
    • thrombosis and embolism;
    • arterial disease;
    • vascular compression by a tumor;
    • mitral valve stenosis;
    • other violations of the structure and functioning of the valve.

    The pathogenesis of the disease is as follows:

    • thickening of the myocardial fibers;
    • increase in blood pressure in the ventricular cavity;
    • myocardial hypoxia, that is, insufficient intake of oxygen to it;
    • violations of the structure of the myocardium, metabolism in it;
    • anatomical changes in the ventricle.

    Hypertrophy does not clinically contribute to the occurrence of certain complaints in patients. As a rule, signs of hypertrophy are manifested as a result of pulmonary hypertension or acute or chronic heart failure. Symptoms of pulmonary hypertension:

    • shortness of breath, appearing even after slight physical exertion or at rest;
    • severe dry cough;
    • dizziness and frequent fainting;
    • a feeling of rapid heartbeat, sometimes at rest;
    • secretion of blood with sputum;
    • various kinds of heart rhythm disturbances;
    • pain behind the sternum, associated primarily with hypoxia of the heart muscle (they stop with nitroglycerin).

    Symptoms of heart failure are as follows:

    • severity in the right hypochondrium;
    • the appearance of a pattern of dilated veins on the skin, especially in the abdomen;
    • swelling of the legs.

    In children, the manifestation of congenital heart defects can be accompanied by the following symptoms:

    • blue skin;
    • severe shortness of breath;
    • heart palpitations;
    • heart rhythm disturbance;
    • lag in physical development.

    There are electrocardiographic signs of hypertrophy:

    • increase in P-amplitude and its duration;
    • P-wave has a pronounced acute shape;
    • the height of such a tooth is sharply increased;
    • the tooth has a symmetrical shape;
    • pathological changes are visible in the second and third lead;
    • the axis of the tooth P moves to the right side.

    It is unlikely that you can read such a cardiogram on your own. When making a diagnosis, the doctor must take into account all the leads. Based on the obtained electrocardiographic data, a specialist may indicate the development of a person’s right ventricular hypertrophy.

    In the later stages of this disease, signs of the so-called pulmonary heart appear. The main symptoms of a pulmonary heart are:

    • 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.

    In the case of pulmonary embolism, quickly, in just a few minutes, a person develops signs of shock with severe pulmonary edema. With pulmonary edema, a massive exit of transudate into the lung tissue from the capillary region appears. 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.

    But in the stage of decompensation, signs of left ventricular failure gradually develop. The manifestation of such decompensation is severe shortness of breath, which does not subside even at rest. It intensifies if a person changes the position of the body, especially when lying down. Other symptoms indicate that a person develops so-called congestive heart failure.

    Diagnosis of the disease

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

    1. 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.
    2. 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.
    3. A thorough analysis of the anamnesis, the collection of complaints may suggest the development of this hypertrophy.
    4. 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.
    5. Examination of the heart using a cardiovisor.
    6. 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.

    The principles of treatment depend on the presence of the underlying disease in the patient. Most often, these are patients with a history of chronic pulmonary pathologies.

    In the case of a congenital heart disease found in a person, doctors use the so-called etiotropic treatment. It is aimed at eliminating or substantially weakening the effect of the main pathological factor. Pathogenetic treatment is used in cases where hypertrophy of the right ventricle is acquired.

    It is very important to correct blood pressure in order to bring it back to normal as much as possible. With pulmonary pathologies, their treatment is necessary in order to prevent the so-called pulmonary heart and decompensated pulmonary insufficiency. Shown are bronchodilators (only after a thorough diagnosis, otherwise they can provoke a complication).

    Prevention comes down to the following:

    • early diagnosis of cardiovascular pathologies;
    • prevention of physical inactivity;
    • refusal from alcohol and smoking (even passive smoking is harmful to the patient);
    • careful observance of all medical recommendations;
    • the use of so-called oxygen cocktails;
    • Spa treatment.

    Hypertrophy of the right ventricle requires special attention from the patient and the doctor. If you suspect you have such a disease, do not hesitate to visit a specialist. Indeed, in the early stages of the development of the disease it is much easier for a person to help. The prognosis of the disease depends on how early a person went to a doctor: it worsens with the development of pulmonary embolism.

    The diagnosis of any disease should be made by the doctor after conducting a full range of studies. Diagnosis of right ventricular hypertrophy includes:

    • Physical examination – examination by a doctor. Often, it is he who prompts the thought of a disease. A competent cardiologist is able to hear heart murmurs and malfunctions in the working rhythm.
    • Electrocardiography But with the help of a cardiogram, you can see only a rhythm disturbance, but not a size violation. That is, it is an indirect diagnosis.
    • Analysis of patient complaints.
    • Echocardiography. This technique using ultrasound makes it possible to determine the parameters of the heart muscle, measure its thickness, detect a violation of the outflow of blood through defects, and assess their size. It makes it possible to measure pressure in the ventricle. Fairly accurate method of determination.
    • ECG.
    • Cardiovisor. This device allows you to observe the dynamics of the heart. It can be used at home.
    • Identification of a hereditary predisposition to the disease.
    • People who are overweight, or, conversely, athletes who receive heavy loads in training and competitions, as well as owners of bad habits, also fall into the risk group. They need to periodically undergo preventive examinations by a cardiologist.

    Causes

    • violation of the structure of the musculoskeletal system (scoliosis, ankylosing spondylitis);
    • decrease in neuromuscular transmission (polio);
    • pathology of the pleura and diaphragm associated with trauma or surgery;
    • severe obesity (Pickwick syndrome).

    Symptoms, causes, diagnosis and treatment of right ventricular hypertrophy

    With the syndrome of right ventricular hypertrophy, treatment should be aimed at normalizing lung function, eliminating pulmonary valve stenosis, and treating heart defects. In addition, treatment should be necessarily symptomatic, that is, aimed at maintaining the work of the heart muscle, its additional nutrition, normalization of the pulse and blood pressure.

    Against the background of right ventricular hypertrophy, therapy should be directed primarily to the cause that causes it, namely:

    • To eliminate stenosis of the pulmonary valve;
    • To normalize the work of the lungs;
    • For the treatment of heart defects.

    In addition, treatment of right ventricular hypertrophy should include symptomatic therapy aimed at normalizing blood pressure and pulse, maintaining the work of the heart muscle and its additional nutrition. As a rule, surgical treatment is indicated in cases when an increase in the right ventricle causes heart disease.

    To maintain a positive effect, some of the prescribed drugs should be taken throughout life. Combined therapy for right ventricular hypertrophy also includes a complete rejection of bad habits, correction of the daily regimen and nutrition. Prevention of prostate hyperplasia primarily consists in regular and timely diagnosis of the state of the heart muscle.

    Treatment of right ventricular hypertrophy should include complex therapy to eliminate concomitant diseases. The doctor prescribes medications that help normalize the functioning of the heart and lungs:

    • 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 key objective of therapy is aimed at normalizing the size of the heart, in particular, its right ventricle. With the development of hypertrophy, the treatment regimen includes such components:

    • the use of drugs – helps to cope with stenosis, normalize lung function, eliminate heart defects;
    • nutrition correction;
    • normalization of lifestyle.

    Important: Treatment should be carried out under the strict supervision of a physician. During therapy, it is necessary to evaluate the function of the heart and determine the frequency of contractions.

    Causes

    • primary pulmonary hypertension;
    • thromboembolic foci in this area;
    • arteriosclerosis of arteries;
    • volume formations in the mediastinum.

    An increase in the mass of the right ventricle occurs with various diseases of the respiratory and circulatory systems.

    Hypertrophy of the right ventricle in the baby is associated with congenital malformations of the heart:

    1. Tetralogy of Fallot, which leads to a violation of the emptying of the right ventricle, as a result of which hypertension occurs in it.
    2. Violation of the integrity of the interventricular septum. In this case, the pressure in the right and left parts of the heart is equalized. This leads to a decrease in oxygenation (oxygenation) of the blood, as well as to hypertrophy.
    3. Stenosis of the valves of the pulmonary artery, which impedes the movement of blood from the heart to the vessels of the pulmonary circulation.
    4. Pulmonary hypertension associated with increased vascular resistance.

    With congenital malformations, hypertrophy appears already at an early age.

    Symptoms

    Symptoms of right ventricular hypertrophy are not specific and are directly related to the causes of the disease. At the very beginning of the pathological process, signs may be absent or not noticeable. However, as myocardial mass increases, the manifestations become more pronounced:

    • sudden dizziness, which may be accompanied by loss of balance and fainting;
    • shortness of breath or feeling short of breath;
    • pain in the chest;
    • arrhythmia, palpitations and interruptions;
    • signs of heart failure (leg swelling, increasing in the evening, an increase in liver pressure and its soreness).
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    Hypertrophy of the right ventricle in a child is often accompanied by a decrease in oxygen concentration in the peripheral blood. As a result, his skin becomes cyanotic, which is especially noticeable when crying.

    Diagnostics

    Diagnosis of an increase in the size and mass of the right ventricle is usually done using standard cardiac examination methods. These include:

    1. Electrocardiography ECG signs of right ventricular hypertrophy can only be determined by an experienced doctor, since this area of ​​the heart makes a much smaller contribution to electrical potential than the left ventricle. By changing the teeth, only the fact of the presence of an increase in the ventricle can be established, however, the dimensions of the chamber themselves cannot be determined.
    2. Ultrasound of the heart (ECHO-KG), in contrast to the previous technique, is much more informative. In this case, it is possible to establish the fact of hypertrophy and its degree, as well as identify the most significant deviations in the structure of the heart. If you supplement the usual ultrasound with dopplerography, then you can visually examine the speed and direction of blood flows flowing, including through pathological vessels and holes.

    Hypertrophy of the right ventricle on an ECG, unfortunately, becomes noticeable only with pronounced and most often irreversible changes. That is why, even normal examination results do not exclude the presence of pathology.

    The greatest diagnostic value in determining hypertrophy is ECHO-KG.

    As the child grows, the load on his heart also increases. If there is any obstacle to the blood flow through the vessels of the small (respiratory) circle of blood circulation, an increase in muscle mass of the right ventricle occurs. According to disappointing statistics, this disease is much more common in children, which is associated with the congenital nature of the pathology.

    With prolonged hypertrophy, secondary damage to the vessels of the lungs occurs. They become more rigid and less elastic, which further aggravates the course of the disease.

    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.

    In case of suspicion of a change in the structure of the myocardium, it is necessary to perform an ultrasound of the heart in the hospital.

    Treatment

    Right ventricular myocardial hypertrophy is most often subject to surgical treatment. At the same time, it is very important to understand that the mass of the myocardium itself is unlikely to decrease and return to normal. Surgical intervention will more likely help prevent the further progression of the disease.

    The technique of surgery in this pathological condition can be of two types:

    1. Open heart manipulations when cutting the sternum and opening the chest. This procedure is rather traumatic and requires a temporary stop of blood circulation. In this way, valve replacement, repair of defects in the muscular septum, and transplantation of a donor organ are performed.
    2. Minimally invasive access is via the femoral artery or jugular vein. At the same time, using special tools, contrast and X-rays, the doctor performs all the procedures on a working heart, practically without damaging the surrounding tissue. Valve prosthetics according to this technique began recently, but occluders (patches) have been placing defects on the muscular septum for a long time.

    Medicines for hypertrophy help eliminate the symptoms or signs of the disease, but do not affect the causes. Commonly used:

    • antiarrhythmic drugs;
    • bronchodilators;
    • magnesium and potassium preparations;
    • metabolic agents (preductal, mexicor);
    • calcium channel antagonists that can reduce pulmonary pressure.

    A specific combination of drugs should be prescribed by a doctor, taking into account all the features of the disease.

    Hypertrophy of the right ventricle of the heart on an ECG. How to treat right ventricular hypertrophy in adults and children

    The growth of the heart muscle increases the load on the right compartment of the baby’s heart, which is much worse and more serious than with the same pathology of its left compartment. The thing is that the pulmonary pulmonary circulation, and, accordingly, the departments serving it, is adapted for normal operation in the field of small pressures.

    If there is a discharge of blood fluid of larger than expected volumes of the left half of the heart or in case of stenosis of the pulmonary artery, the pressure of the small circle increases, the load on the right compartment of the heart muscle also automatically increases. And in order to cope with the increased loads, the heart muscle of the right ventricle has no choice but to build up mass, increasing in size.

    In this case, the right ventricular hypertrophy develops in the child. Monitoring the maximum number of cases of the manifestation of the disease has led doctors to conclude that this disease is more common in children than in adults. In a little man, this disease can occur in the first days of his life and have a purely physiological character under him, since during this period the load on this particular half of the heart increases significantly.

    But these cases are quite rare. The largest percentage of right ventricular hypertrophy disease still occurs in cases of congenital heart disease, the symptoms of which are already evident in the first days of a child’s life. Not only constituent hearts, but also vessels with arteries that enter the pulmonary system are exposed to increased stress.

    And if the increased load persists for a sufficiently long time, then the vessels become harder, which starts the vascular sclerotization procedure. Which, in turn, leads to a decrease in plasma permeability of the pulmonary ring, the pressure in the small circle rises, leading to a disease that is called Eisenmenger’s syndrome in medicine.

    And the symptoms of this disease are already irreversible. Drawing a conclusion from all of the above, it is necessary to understand that hypertrophy of the right ventricle is serious and it is impossible to let the problem arise by gravity. In this situation, urgent medical intervention is necessary to prevent further adverse development of events.

    Various age categories are subject to an increase in the volume and mass characteristics of the ventricle, but nevertheless, hypertrophy of the right ventricle in a newborn (the so-called congenital pathology – heart disease) is more common in percentage terms than all other cases. The cause of this disease in very small, newborns , children, cardiologists consider:

    • increased load, which affects the right region of the heart even in the womb or in the first days after birth.
    • dysfunction of the outflow of blood from the right ventricle, which leads to congenital pathology – hypertrophy of the right ventricle.
    • Anatomical defects in the cardiac septum can also lead to pathological changes in the blood supply system. That is, there is no hermetic separation of one cavity of the heart from another, which leads to a mixture of blood flows. In this case, the blood is poorly saturated with oxygen, and, consequently, the whole body of the human body lacks it, which leads to a systemic pathology. And in order to make up for the lack of oxygen in the organs, the heart has to work with great effort. And as a result – hypertrophy.
    • Also, the cause of this pathology in newborns can be called stenosis of the valve of the lungs.

    Young mothers should understand that in the event of any symptoms that deviate from the norm, you should not fall into despair and make your own diagnoses. It is best to contact your pediatrician as soon as possible, and he, if necessary, will refer to pediatric cardiologists and only he can confirm or refute this diagnosis. The sooner you contact your baby at the clinic, the faster and more gentle the treatment will be for your child.

    The heart is the main organ of man. If one of its four parts starts to work incorrectly, the whole body fails. Right-sided ventricular hypertrophy is one of the pathological conditions that is associated with an increase in the myocardium. This defect indicates the development of serious complications in the work of the lungs and heart.

    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.

    With the growth of the baby, the load on the heart increases. With circulatory problems there is a risk of an increase in the mass of the right ventricle. With prolonged presence of hypertrophy, secondary damage to the vessels of the lungs is observed. They become more rigid and lose their elasticity. This provokes an aggravation of the symptoms of the disease. Hypertrophy of the right ventricle of the heart in a child occurs under the influence of the following factors:

      anomaly in the structure of the heart septum (DMS);

    Symptoms of the disease may not appear immediately, but only after a while. Therefore, for any symptoms of impaired myocardial structure, an ultrasound examination after birth should be done. In children, this anomaly is much more common.

    Hypertrophy of the right and left ventricle

    Hypertrophy of the right and left ventricle is, in some sense, a harbinger of a more serious disease caused by an increase in the myocardium. At the same time, it is a complex pathology, due to a significant increase in muscle tissue of the heart, while the volumes of the cavities of the ventricles remain unchanged. Hypertrophy of the left myocardium. The work of the left ventricle provides the functionality of a large circle of blood circulation. If there is a violation in his work, a person begins to feel:

    • Pressive pain in the chest.
    • Suddenly dizziness.
    • Frequently recurring syncope.
    • The patient feels a breakdown and apathy.
    • Sleep may be disturbed.
    • Disturbances in the functioning of the human nervous system are traced.
    • Arrhythmia appears.
    • Dyspnea makes breathing difficult. Moreover, it occurs not only against the background of physical exertion, but also at rest.

    Hypertrophy of the right myocardium. Its consequences are more destructive for the patient’s body, since the work of the right ventricle is responsible for the small circulation cycle, which has a normal working pressure lower than in a large circuit. Therefore, with increasing pressure in it, the body suffers much more.

    Electrocardiographic findings for pancreatic hypertrophy

    1. If, in the presence of signs of pancreatic hypertrophy, the high R wave in leads V1, V2 does not combine with changes in the ST segment and T wave, then it is customary to give a conclusion on pancreatic hypertrophy (Fig. 64).

    Fig. 64. ECG for pancreatic hypertrophy. 2. If, with electrocardiographic signs of pancreatic hypertrophy, a high R wave in leads V1, V2 is combined with a decrease in the ST segment and a negative T wave in these leads, then they speak of pancreatic hypertrophy with overload, and less commonly, the term pancreatic hypertrophy with myocardial dystrophy (Fig. 65).

    Fig. 65. ECG with pancreatic hypertrophy with overload. 3. If, with pancreatic hypertrophy, a high R in leads V1, V2 is combined with a decrease in the ST segment and a negative T wave not only in these leads, but also in other leads (for example, from V1 to V4), then they talk about pancreatic hypertrophy with overload and pronounced myocardial changes ( fig. 66).

    Fig. 66. ECG with pancreatic hypertrophy with overload and pronounced myocardial changes.

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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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