Blood from the right ventricle of the heart. Useful information about right ventricular hypertrophy. Features of the disease in children

Disease Definition

Hypertrophy of the ventricle of the heart this is a complex of pathological and physiological symptoms, characterized by a significant increase in the walls of the ventricle, the volume of its cavity remains unchanged. This is a kind of syndrome that warns of an increase in the myocardium, which can become a serious illness.

The physiological reasons leading to hypertrophy of the ventricle of the heart are too much physical activity, incommensurable with the abilities of the body. Pathological causes include hereditary and acquired pathologies. Congenital pathology is most often observed in the left ventricle, is detected at an early age, but is asymptomatic. Symptomatic manifestations are especially pronounced during puberty.

Hypertrophy of the left ventricular myocardium

The walls of the left ventricle contain striated muscle fibers, connective tissue cells and ground substance. The left ventricle provides blood flow through the systemic circulation. The contractile functions of its walls contribute to the expulsion of blood into the aorta, after which it enters the systemic circulation.

The first signs of hypertrophy of the left myocardium of the ventricle of the heart appear when the blood supply and the size of the left ventricle do not match. People feel pain in the chest, get tired quickly, suffer from dizziness. fainting is frequent. There is a violation of the nervous system, which entails the appearance of arrhythmia.

Left atrial insufficiency is manifested by shortness of breath not only during physical exertion, but also in a calm position.

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Hypertrophy of the right ventricle of the heart

The right ventricle lets blood through, pushing it into the vessels that connect to the lungs. There it is enriched with oxygen. The right side of the heart and the lungs are interconnected, so various problems of the respiratory system lead to ventricular hypertrophy.

In medicine, the main causes of such a pathology have been established.

Enlargement of the right ventricle occurs due to diseases such as chronic bronchitis and pneumonia. Changes occur after emphysema and pulmonary fibrosis, bronchial asthma and pneumosclerosis. Right ventricular hypertrophy is caused by mitral stenosis or congenital heart disease.

The right ventricle is three times smaller than the left ventricle, so the electrical activity of the left ventricle is greater. Hypertrophy of the right ventricle is pronounced when its mass exceeds the mass of the left. With moderate hypertrophy, the right ventricle is enlarged, but not larger than the left, and slight excitation is observed.

With moderate hypertrophy, the right ventricle is enlarged, but its mass does not exceed the mass of the left ventricle. At the onset of the disease, symptoms are always mixed or absent. If there is a tendency to a stable increase in size, then the symptoms of right ventricular hypertrophy are expressed by the fact that it is difficult for a person to breathe, heaviness in the chest is felt, and pain occurs.

In addition, patients can observe a fluttering of the heart or a fading and delay in heart beats. There may be bouts of dizziness and loss of consciousness.

Treatment is selected after the diagnosis is established and depending on the causes of the problem.

There is an etiotropic method used for congenital pathologies. The atogenetic method helps to influence pathological changes in the physiological parameters of the ventricle. Today, these methods normalize blood pressure, treat obesity, and contribute to the correction of defects.

The treatment course also involves the use of drugs that slow down the development of hypertrophy. Left ventricular hypertrophy has no age limits, it occurs at a young and old age, is a common cause of sudden death from a stroke or heart attack.

Examination of patients with suspected ventricular hypertrophy is carried out after examination by a cardiologist. After that, an electrocardiogram is performed, an ultrasound, an echocardiogram is used. The blood must be tested. The doctor prescribes drugs, having carefully studied the anamnesis - these are beta-blockers and verapamil.

During treatment, you need to constantly monitor the work of the heart, observe the daily regimen, diet. Alcohol and smoking while taking beta-blockers are contraindicated. But it will be very useful - swimming, aerobics, running, physiotherapy exercises.

Unfortunately, people with this pathology need to take drugs for life. If there is a threat to life, i.e., the walls of the heart thicken, disrupting the blood supply to the brain and other organs, then most likely the doctors will insist on an operation. Nowadays, thanks to modern technology, such surgical interventions are no longer something new, and therefore you should not beware of them.

Causes and treatment of left and right ventricular hypertrophy

What is hypertrophy?

Hypertrophy is a pathological process that is accompanied by an increase in the volume of the cells themselves, as well as their number. As a result, there is an increase in the mass of tissues, which is often accompanied by a violation of their functions. If such changes occur with the heart muscle, myocardial hypertrophy occurs.

The human heart has four chambers, two of which are the ventricles and two more are the atria. The main function of this organ is pumping, that is, it is responsible for the non-stop circulation of blood in the body. Collecting from other organs, the fluid enters first into the atrium, and then into the ventricle.

Due to the reduction of the latter, a constant pressure in the vessels is maintained. Normally, the thickness of the ventricles is much higher than that of the atria, which is associated with a high load on the cells of this region of the heart. There are a number of pathological conditions that can cause hypertrophy of the right, left, or both ventricles.

Causes of hypertrophy

Usually the left ventricle has the largest mass, since blood flows from it to all peripheral tissues and organs, excluding the lungs. It is the pump that pumps blood around in a big circle.

The causes of left ventricular tissue hypertrophy may be associated with increased resistance of these vessels, for example, in aortic stenosis. In this case, the muscles of the ventricle require additional force to push the blood into the arteries. A similar condition sometimes occurs due to the chronic course of hypertension. Due to the constant high pressure the load on the left ventricle increases sharply, which leads to its hypertrophy.

The right ventricle is normally less massive than the left. It pushes blood into the vessels of the small (pulmonary) circle, through which it enters the tissue of the alveoli. Once in the capillaries, hemoglobin in the blood is enriched with oxygen and releases the accumulated carbon dioxide.

Hypertrophy of the myocardium of the right ventricle is most often the result of diseases of the respiratory system or narrowing of the lumen pulmonary artery, which is accompanied by the development of congenital hypertension.

In order to correctly prescribe therapy for hypertrophy, it is necessary to conduct a complete examination and find out the degree of disruption of the heart.

Treatment Methods

Due to the fact that hypertrophy is only a manifestation of any abnormalities, and not an independent disease, before starting treatment, it is necessary to establish the cause of this pathological condition. Further tactics will directly depend on the primary disease.

Drug treatment of right ventricular hypertrophy of the heart is most often aimed at normalizing the function of the respiratory system. The following groups of drugs are usually used:

Treatment of left ventricular myocardial hypertrophy caused by hypertension are performed using the following drugs:

ACE inhibitors not only reduce blood pressure by acting on the renin-angiotensin-aldosterone system, but also prevent disruption of the structure of the heart.
Beta-blockers (anaprilin, concor) reduce the heart rate and help reduce the load on the muscle. Due to this, the severity of hypertrophy is reduced.
Diuretic drugs (lasix, indapamide) accelerate the excretion of fluid from the body, reduce intravascular blood volume, thereby reducing systemic pressure.
Angiotensin receptor antagonists have a similar mechanism of action to ACE inhibitors.

For the treatment of hypertrophy of both ventricles of the heart, drugs are also used that resist the consequences. These include:

antiarrhythmic drugs that help with various heart rhythm disorders;
cardiac glycosides, which improve the function of the left ventricle;
metabolic drugs (riboxin, ATP, mexicor, etc.) that improve the functioning of myocytes.

Drug therapy helps to cope with the symptoms of hypertrophy, but has little effect on the underlying cause.

In case of ineffectiveness of the selected treatment, as well as in the diagnosis of severe acquired or congenital malformations, only surgical treatment can improve the situation.

Surgery

In the treatment of right ventricular hypertrophy, surgery is usually performed at an early age. The efforts of the surgeon can be directed to prosthetic valves or removal of pathological openings and vessels. However, sometimes the causes of such changes are associated with an incurable congenital pathology of the respiratory system, which can be dealt with only by transplanting the entire heart-lung complex or only the lungs.

Operative tactics in most cases slows down the increase in the mass of muscle cells of the ventricles and helps to eliminate the cause of the disease.

For the treatment of left ventricular myocardial hypertrophy, prosthetics of one or more valves are usually used. Most often, the causes of these pathological changes are associated with a narrowing of the outflow tract, which includes the aorta and its valve. The mitral valve is also involved. In this case, several types of surgical intervention are performed:

Aortic valve replacement only. The operation can be performed in the traditional way with the opening of the chest or in a minimally invasive way, when the valve is delivered to a predetermined position in the folded state through a puncture in the femoral artery.
Valve prosthesis together with part of the aorta. This intervention is more traumatic and requires a lot of experience of the surgeon. The prostheses themselves can be artificial or biological, made from processed pig tissues.

In some cases, the treatment of hypertrophy of both ventricles of the heart is possible only with the help of donor organ transplantation. Before performing such an operation, it is necessary to perform a large number of compatibility tests, and after the intervention, drugs should be taken to prevent the development of a rejection reaction.

Since only a doctor can develop an effective treatment strategy, it is necessary to trust a competent specialist.

Right ventricle

The right ventricle is the chamber of the human heart, in which the pulmonary circulation begins. There are four chambers in the heart. Venous blood enters the right ventricle from the right atrium at the time of diastole through the tricuspid valve and is pumped at the time of systole through the pulmonary valve into the pulmonary trunk.

The structure of the right ventricle

The right ventricle is bounded from the left posterior and anterior by interventricular sulci on the surface of the heart. It is separated from the right atrium by the coronal sulcus. The outer edge of the ventricle has a pointed shape and is called the right edge. In shape, the ventricle resembles an irregular trihedral pyramid, with the base pointing up and to the right, and the apex pointing to the left and down.

The posterior wall of the ventricle is flat, while the anterior wall is convex. The inner left wall is the interventricular septum, it has a convex shape (convex towards the right ventricle).

If you look at the right ventricle in a section at the level of the apex of the heart, it looks like a gap, elongated in the anteroposterior direction. And if you look at the border of the middle and upper thirds of the heart, then it resembles the shape of a triangle, the base of which is the septum between the ventricles, protruding into the cavity of the right one.

There are two sections in the cavity of the ventricle: the posterior wide and the anterior narrower. The anterior section is called the arterial cone, it has an opening through which it connects to the pulmonary trunk. The posterior section communicates with the right atrium through the right atrioventricular orifice.

On the inner surface of the posterior section there are many muscle bars that form a dense network.

Around the circumference of the atrioventricular opening, the right atrioventricular valve is attached, which prevents the reverse flow of blood from the ventricle to the right atrium.

The valve is formed by three triangular leaflets: anterior, posterior and septal. All valves protrude with free edges into the cavity of the ventricle.

The septal leaflet is located closer to the ventricular septum and is attached to the medial part of the atrioventricular orifice. The anterior leaflet is attached to the anterior part of the medial opening, it faces the arterial cone. The posterior leaf is attached to the posterior part of the medial opening. Often, a small additional tooth can be seen between the posterior and septal valves.

The opening of the pulmonary trunk is located on the left and in front and leads to the pulmonary trunk. Three shutters can be seen along the edges of the hole: front, left and right. Their free edges protrude into the pulmonary trunk and together they form the valve of the pulmonary trunk.

Diseases associated with the right ventricle

The most common diseases of the right ventricle are:

Stenosis of the pulmonary trunk;
Hypertrophy of the right ventricle;
Right ventricular infarction;
Blockade of the right ventricle.

Pulmonary stenosis

Stenosis is an isolated narrowing of the pulmonary artery. The narrowing of the exit to the pulmonary artery can be located at different levels:

Subvalvular stenosis of the pulmonary artery is formed as a result of the growth of fibrous and muscular tissue in the infundibular section of the ventricle.
Stenosis of the fibrous ring is formed at the site of transition of the myocardium of the right ventricle into the pulmonary trunk.
Isolated valvular stenosis is the most common cardiac pathology (about 9% of congenital heart defects). With this defect, the pulmonary valve is a diaphragm with a hole with a diameter of 2 to 10 mm. The division into valves is often absent, the commissures are smoothed.

With pulmonary stenosis, the pressure in the right ventricle increases, which increases the load on it. As a result, this leads to an increase in the right ventricle.

Right ventricular hypertrophy

In fact, right ventricular hypertrophy is not a disease, rather it is a syndrome that indicates an increase in the myocardium and causes a number of serious diseases.

The enlargement of the right ventricle is associated with the growth of cardiomitocytes. As a rule, this condition is a pathology and is combined with other cardiovascular diseases.

Enlargement of the right ventricle is quite rare and is often diagnosed in patients with diseases such as pneumonia and chronic bronchitis, pulmonary fibrosis and emphysema, pneumosclerosis, bronchial asthma. As mentioned above, right ventricular hypertrophy can be caused by stenosis or congenital heart disease.

The mass of the right ventricle in the normal state is approximately three times less than the mass of the left. It is with this that the predominance of the electrical activity of the left ventricle in a healthy heart is connected. Against this background, right ventricular hypertrophy is much more difficult to detect on an electrocardiogram.

Based on the degree of enlargement of the right ventricle, the following types of hypertrophy are distinguished:

Pronounced hypertrophy - when the mass of the right ventricle exceeds the left;
Medium hypertrophy - the left ventricle is larger than the right one, however, in the right there are excitation processes associated with its increase;
Moderate hypertrophy - the left ventricle is much larger in mass than the right one, although the right one is somewhat enlarged.

right ventricular infarction

Approximately 30% of patients with inferior infarction have some degree of involvement of the right ventricle. Isolated right ventricular infarction occurs much less frequently. Often an extensive infarction leads to severe right ventricular failure, in which there is a symptom of Kussmaul, swelling of the jugular veins, hepatomegaly. Arterial hypotension is possible. On the first day, there is often a rise in the ST segment in additional chest leads.

The degree of damage to the right ventricle can be detected using an echocardiogram.

Right ventricular block

Right ventricular block occurs in about 0.6-0.4% of healthy people. The prognosis of this disease depends on heart disease. For example, with an isolated blockade, the prognosis is quite favorable, since there is no tendency to develop coronary heart disease.

Right ventricular block may develop as a result of pulmonary embolism or anterior infarction. If the blockade occurs as a result of a heart attack, the prognosis is negative, since heart failure and sudden death often occur in the first months.

Block resulting from pulmonary embolism is usually transient and occurs predominantly in patients with severe pulmonary artery disease.

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Right ventricular hypertrophy (RVH) is a serious pathology characterized by an increase in the size and mass of the right ventricle, which occurs as a result of a change in the number of cardiomycytes (muscle cells of the heart).

In the 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 cardio-vascular system:

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

Catalysts for the growth of cardiomycytes, which leads to the progression of pathology, can be various 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 neuroses.

Another factor provoking the development of right ventricular hypertrophy may be an excessive passion for aerobic physical activity.

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

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

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

The lack of therapeutic measures in the acute form of the course of right gastric hypertrophy can lead to the death of the patient.

Also, GPZH syndrome is classified according to the type of occurrence:

physiological (congenital), when 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 (bluish skin tone) of the face or the whole body.
pathological (acquired) - the syndrome of enlargement of the right ventricle occurs as a result of bronchopulmonary ailments or physical overload.

Symptoms of BPH

In the acquired form, this syndrome is characterized by the absence of specific symptoms by which right gastric hypertrophy can be determined.

Signs of right ventricular hypertrophy are similar to the manifestations of many other ailments and at the initial stage of development of the 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.

These signs include:

prolonged pain in the right sternum of a sharp, stabbing character;
dyspnea;
dizziness, accompanied by 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 towards the end of the day.

The main clinical signs of BPH include an increase in heart rate (tachycardia) and a sharp decrease in blood pressure.

Diagnostic methods

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

aortic sclerosis;
hypertension of the pulmonary circulation;
Eisenmenger's syndrome (exceeding pressure in the pulmonary artery over the aortic one).

Timely diagnosis of BPH can not only prevent the development of these pathologies, but also greatly facilitate the fight against the syndrome as a whole. It is possible to confirm or refute the presence of right gastric hypertrophy only thanks to apparatus cardiological studies:

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

As a method of diagnosing GPZh is less indicative. Right ventricular hypertrophy on the ECG is expressed only in a change in the cardiogram teeth, which can only indicate the fact of a change in the size of the ventricle, the severity of the pathology cannot be determined in this way.

The RVH syndrome on electrocardiography is "highlighted" only with moderate and acute forms currents.

An echocardiogram has a 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 dimensions, as well as to diagnose defects in the structure of heart tissues.

Echocardiography as a method for diagnosing BPH is often combined with Doppler sonography, which makes it possible to additionally investigate the direction and speed of blood flows.

This method of research makes it possible to determine right gastric hypertrophy even in a moderate form of the course, due to which it is possible to prevent the progression of the growth of cardiomycytes in the heart muscle.

Treatment and prevention of the disease

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

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

Drug treatment of GPZh consists in eliminating the symptoms of the pathology by taking medicines from various pharmacological groups:

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

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

Prevention of BPH in the first place is the 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 suffered from various bronchopulmonary diseases, as well as athletes who are fond of cardio training.

As you know, the blood from the right ventricle enters the lungs through the pulmonary circulation, enriching them with oxygen. And from the left it flows into the systemic circulation. Therefore, right ventricular hypertrophy is directly related to pulmonary diseases, including pulmonary insufficiency.

For various reasons, including increased physical activity, the muscles of the ventricles can increase in size. This condition is called ventricular hypertrophy.

Right ventricular hypertrophy - pathological condition, at which there is an increase in the myocardium, which leads to the development of serious ailments. The change in the size of the heart is associated with the growth of specialized heart cells - cardiomyocytes.

Hypertrophy is not an independent disease, but is considered a symptom of any cardiovascular disease.

Usually, changes in the muscles of the heart occur by the age of 50-60. Hypertrophy is rarely seen in young people, but it is often diagnosed in very young children, including newborns with congenital heart defects. Hypertrophy in a newborn manifests itself immediately in the form of extensive cyanosis of the face, as well as the fingertips and other departments. Sometimes the disease is only physiological in nature and manifests itself in children in case of an increase in the load on the heart.

It is known that hypertrophy of the right ventricle is much less common than that of the left. Normally, the left ventricle weighs 3 times less than the right one. And even after an increase in the right, the weight of the left ventricle still remains less.

Causes

The following factors influence the increase in the size of the right ventricle:

high blood pressure in the pulmonary artery (pulmonary hypertension) - the condition is characterized by dizziness and fainting, shortness of breath at rest;
narrowing of the pulmonary valve located at the exit site of the pulmonary artery;
defects of the interventricular septum, in which the blood of the right and left ventricles mixes (in such cases, the blood does not contain the necessary amount of oxygen and the heart compensates for this deficiency by increasing the contractions of the ventricles - as a result, both ventricles increase);
Tetralogy of Fallot, in which 4 deviations from normal parameters occur: right ventricular hypertrophy, ventricular septal defect, narrowing of the pulmonary valve, displacement of the aorta to the right (the defect is also called "blue", as it is characterized by blueing of many parts of the body);
certain lung diseases (chronic pneumonia, bronchitis chronic stage pneumosclerosis, emphysema).

Symptoms of right ventricular hypertrophy

In the early stages of the disease, right ventricular hypertrophy is mild, but in the latter stages, the following signs can be observed:

feeling of severe pain in the sternum, a feeling of heaviness and difficulty in breathing;
arrhythmia and palpitations (tachycardia), which patients characterize as a kind of flutter in the chest;
sudden bouts of dizziness, fainting;
swelling of the lower extremities.

Clinical manifestations of right ventricular hypertrophy are also called "cor pulmonale", the stages of which are chronic and acute. The main cause of cor pulmonale is considered to be pulmonary embolism, which is multiple and massive.

The acute clinical picture is characterized by right ventricular failure, severe shortness of breath, tachycardia, and a decrease in blood pressure. Often, acute right ventricular failure ends in the death of the patient.

The chronic form differs little from the acute one until the decompensation process sets in. Severe cases of the chronic stage most often end with chronic obstructive pulmonary disease.

Treatment

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

drug treatment (elimination of stenosis, normalization of the lungs, treatment of heart defects);
adjusting the diet and lifestyle of the patient.

In addition to the main intake of diuretics, beta-blockers and calcium channel antagonists, drugs are also prescribed to normalize lung function and eliminate pulmonary valve stenosis. In some cases, most of the drugs will have to be taken throughout life.

Therapy is carried out under the regular supervision of a specialist. During treatment, the work of the heart is systematically checked, the frequency of its contraction.

In the absence of positive dynamics of treatment, the patient is recommended surgical intervention. In the case of progression of hypertrophy and the development of heart disease, surgical intervention 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 have been diagnosed with hypertrophy.

In the event that the source of cardiac hypertrophy is identified, treatment is directed to the elimination of the underlying disease. Self-medication in such cases is unacceptable. fat people and those who are periodically subjected to physical activity, it is recommended to be observed by a cardiologist.

Preparations

Drug treatment of hypertrophy consists in taking the following drugs:

regular use of diuretics;
beta-blockers (incompatible with smoking and alcohol);
calcium channel antagonists;
preparations of potassium and magnesium;
anticoagulants;
minimum doses of cardiac glycosides;
drugs to lower blood pressure.

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

analeptic;
broncholithin;
bromhexine;
eufillin;
nefidipine;
nitrosorbitol;

Folk methods

Folk methods for the treatment of right ventricular hypertrophy, due to low efficiency, are little used. Their use is possible only as sedatives and sedatives, as well as strengthening the heart muscle.

A popular plant is the lily of the valley. The following recipes are known:

Take fresh lily of the valley flowers and pour 96% alcohol. It should be insisted for 2 weeks, after which it is filtered and taken 20 drops three times a day.
Pour a large spoonful of lily of the valley flowers with 300 ml of boiling water, leave for 1 hour. Then strain and take two large spoons every two hours.
A mixture of motherwort and lily of the valley is effective. Prepare an infusion of these plants and take 3 or 4 times a day.
Mix the plant stinging nettle and honey in different proportions. Insist in a dark room for up to 14 days, then heat in a water bath to a liquid state and strain. The infusion is stored in the refrigerator. Take 4-5 times a day.

Diet

In the diet, it is recommended to saturate with plant products, eat more fermented milk products, lean meat and grains. Salt should be limited to a minimum, fried, pickled and smoked dishes should be removed from the table. It is recommended to limit the consumption of sweets, pastries, animal fats. Replace highly carbonated sugary drinks with still or slightly carbonated water.

Right ventricular hypertrophy or right ventricular hypertrophy is a pathological condition of the right ventricle of the heart, which is characterized by a change in its size due to an increase in the volume of muscle tissue, which causes an overload of the heart.

This condition is most common in childhood and old age and can be caused by congenital heart disease, changes in the interventricular septum, pulmonary hypertension, pulmonary valve stenosis.

The disease is manifested by pain and a feeling of heaviness in the chest, shortness of breath and tachycardia, dizziness, fainting, swelling of the legs.

Treatment of right ventricular hypertrophy is reduced to the normalization of lung activity, the treatment of heart defects, the elimination of pulmonary valve stenosis. In some cases, surgery is used.

Causes of right ventricular hypertrophy

Right ventricular hypertrophy is much less common than left ventricular hypertrophy.

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;
Tetralogy of 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, ventricular septal defect. This defect is also called the "blue" defect, since its main symptom is the blueness of various parts of the body;
Ventricular septal defect. With this defect, two parts of the heart communicate with each other, as a result, blood is mixed, which leads to an insufficient supply of oxygen to the organs. The heart tries to compensate for the lack of nutrition of the organs by increasing the contractions of the ventricles, which leads to an increase in both ventricles;
Pulmonary diseases (chronic bronchitis, chronic pneumonia, pneumosclerosis, emphysema).

Physiological hypertrophy is facilitated by systematic aerobic exercise. Therefore, an increase in the size of the heart is quite often observed in people who play sports and lead active image life.

Signs of right ventricular hypertrophy

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

At later stages, signs of right ventricular hypertrophy appear:

Feeling of heaviness and severe pain in the chest;
Difficulty breathing;
Arrhythmia, palpitations. Quite often, patients feel a feeling of "flutter" of the heart in the chest;
Sudden attacks of dizziness. Fainting states;
Severe swelling in the legs.

The clinical picture of right ventricular hypertrophy may also be accompanied by "cor pulmonale", the cause of which is pulmonary embolism. Acute pulmonary heart is characterized by acute right ventricular failure, severe shortness of breath, low blood pressure, tachycardia. Most often, acute right ventricular failure is fatal.

Chronic cor pulmonale has the same clinical picture as acute cor pulmonale until the process of decompensation occurs. In severe forms of chronic right ventricular failure, chronic obstructive pulmonary disease occurs.

Diagnosis of right ventricular hypertrophy

Diagnosis of right ventricular hypertrophy is based on the patient's complaints, the results of his examination, ultrasound data and electrocardiography.

On an electrocardiogram, signs of right ventricular hypertrophy may look like:

R-type. It typically has a QRS complex like gR or Rs. This type of deviation is usually found with severe right ventricular hypertrophy;
rSR1-type. Characterized by a V1 split QRS complex with 2 positive waves;
S-type. It is characterized by the presence of a QRS complex in all chest leads and RS with a pronounced S-wave;

When making a diagnosis, the size of the right ventricle matters. This indicator determines the type of right ventricular hypertrophy, which can be:

Moderately expressed. When the myocardial walls are enlarged, but specific gravity the right ventricle is smaller than the left ventricle;
Expressed. When the weight of the right ventricle remains less than the weight of the left, but the duration of excitation of the heart muscle is longer in the right ventricle than in the left;
Sharply expressed. In the case when the weight of the right ventricle exceeds the weight of the left.

An electrocardiogram allows you to diagnose only a failure in the electrical conduction of the ventricles, the dimensions of the ventricle are established using an ultrasound examination of the heart, which also allows you to identify the defects in it and their locations, the strength of blood pressure in the heart chambers, and the ejection of blood through the defect sites.

Treatment of right ventricular hypertrophy

The choice of methods for the treatment of right ventricular hypertrophy depends on the reasons that led to the development of this condition.

The goal of treatment is to normalize lung function, treat heart defects and eliminate narrowing of the pulmonary valve. 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 pulse.

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

Patients with right ventricular hypertrophy must follow a special diet without fail, adhere to the correct daily regimen, give up smoking and alcohol. Especially effective in this condition are aerobics, swimming, exercise therapy, and 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 the condition of their hearts in order to prevent the development of right ventricular hypertrophy and, as a result, serious heart diseases.