Hypertrophy of the right atrium

The term hypertrophy is introduced to refer to the compensatory increase that arose as a result of any deficiency or deficiency. Hypertrophy of the right atrium is less common than the left one, since the latter experiences relatively large functional loads.

The heart has four departments, capable of increasing in volume against the background of negative reasons. An exception and physiological norm is the growth of the cardiac volume due to regular aerobic training with professional athletes and people leading an active lifestyle. Pathological proliferation of cells of the cardiac tissue (cardiomyocytes) often entails co-morbid diseases. The hypertrophy of one of the cardiac chambers is characterized by its own peculiarities and has only its characteristic symptomatology. It should be noted that hypertrophy does not belong to independent diseases, but is a syndrome of a set of disorders that led to an unfavorable state.

Hypertrophy of the right atrium, as a result of changes in the small circle of blood circulation, occurs with respiratory disorders, is caused by the pathology of the tricuspid valve or vessels, often due to congenital heart defects. These diseases lead to hypertension of the pulmonary artery and significant cardiac congestion, which increases the atrium to the right and causes its insufficiency.

[1], [2], [3], [4]

Causes of right atrial hypertrophy

Hypertrophy of the right atrium may be caused by overweight or obesity, rib deformation, a strong emotional outburst, various addictions (for example, alcohol).

Types of hypertrophy are divided depending on the factors affecting the functioning of the heart:

• myofibrillar or working - develops against a backdrop of intense stress or persistent overstrain of a healthy organism;
• substitutive - the result of adaptability of the heart to normal regimen for various disease states;
• regenerative - after a heart attack, a scar forms in its place, and the cardiomyocytes located around it expand, taking away the functions of the lost zone.

There are following causes of hypertrophy of the right atrium:

• pulmonary pathology - bronchitis or obstructive pulmonary chronic type of disease can increase blood pressure in the pulmonary artery, which takes blood from the ventricle on the right;
• embolism of the artery of the lung - the lungs communicate with the right ventricle through the artery, carrying blood for purification with subsequent oxygen saturation. The formation of a thrombus in the arteries of the lung interferes with free blood flow, which causes an increase in the load on the heart muscle, which seeks to resume the anatomically correct flow of blood. And maximum efforts are observed in the right heart chambers;
• stenosis of the tricuspid valve - a septum located between the atrium and the ventricle on the right, helps the blood to circulate normally from the right atrium to the right ventricle. Reducing the lumen of the valve (stenosis) reduces the amount of flowing blood. To get rid of stagnation, the pressure in the atrium chamber on the right increases, but functioning in an elevated mode leads to dilatation and hypertrophy;
• insufficiency of the tricuspid valve - changes in the tricuspid valve due to the impossibility of its complete closure and the reverse flow of blood from the ventricle to the atrium;
• often hypertrophy of the right atrium - a consequence of an increase in the ventricle on the right;
• congenital heart defects - these diseases are characterized by problems with the tricuspid, mitral or valve of the pulmonary artery. Any change in the structure of the heart leads to dysfunction of the blood flow and subsequently to hypertrophy.

[5], [6], [7], [8], [9], [10], [11], [12], [13], [14]

Signs of hypertrophy of the right atrium

Hypertrophy of the right atrium is expressed by painful sensations in the chest, respiratory disorders, and fatigue. Often unfavorable symptoms are preceded by: transferred pneumonia, exacerbation of bronchial asthma, embolism of the artery of the lung, and the like. After the treatment of the underlying disease, anxious manifestations can subside and even completely disappear. In addition to clinical manifestations of pulmonary problems, with hypertrophy, signs of venous stasis are possible. Disturbing signs of right atrial hypertrophy are characterized by:

• cough, shortness of breath, impaired breathing function;
• edema;
• pallor of the skin, cyanosis;
• blunting of attention;
• minor tingling, discomfort in the heart;
• pathology of the heart rhythm.

In most cases, hypertrophy is asymptomatic, and the manifestation of clinical symptoms is noted already in the advanced stage. Immediately consult a doctor if noticed - palpitations, dizziness (loss of consciousness), swelling of the lower extremities.

Hypertrophy of the right atrium in pregnancy

To fairly complex extragenital diseases in bearing a baby include cardiovascular pathologies. Any pregnancy is characterized by the dynamics of a gradual, constant, sometimes sudden type with obvious physiological and hormonal changes. The cardiovascular system undergoes enormous loads in the course of pregnancy, for this reason it is important to establish a correct diagnosis in a timely manner, as well as assess the woman's ability to bear and give birth. Ideal option will be the decision of the issue of admissibility of pregnancy before conception, to prevent health risks and threat to the life of the mother and baby.

It is known that hypertrophy of the right atrium during pregnancy is not an independent violation. The disease can be caused, both congenital and acquired, including during the period of gestation, pathologies. To monitor the condition, pregnant women with heart problems are shown hospitalized three times for the entire period. The first hospitalization is necessary for a thorough examination of the defect, determining the activity of the pathological process and the functioning of the circulatory system, and considering the possible termination of pregnancy. Repeated hospitalization is required because of the peak physiological stress to maintain cardiac efficiency. Staying in the hospital for the third time helps specialists determine the mode of delivery.

Consequences of hypertrophy of the right atrium

Pathologies of the lungs of a chronic type adversely affect the small circle of circulation and form an excessive number of connective tissue, reduce the gas exchange area and the volume of microcirculation. Such disorders create excessive pressure in the vessels of the lungs, which in turn result in an active contraction of the right heart cavities, which after a while are hypertrophied.

The following consequences of hypertrophy of the right auricle distinguish:

• imminent dilatation (expansion) of the cardiac department;
• lack of blood flow in both circles;
• the appearance of the pulmonary heart;
• venous congestion;
• development of edema;
• detection of cyanotic skin;
• dyspnea.

Progression of the disease causes the malfunction of other internal organs.

[15], [16], [17], [18], [19]

Diagnosis of right atrial hypertrophy

As practice shows, at the stage of physiological examination the doctor sets the hypertrophy of the myocardium. In the arsenal of a specialist, the technique of auscultation is the evaluation of the internal organs by listening. The study of the patient with a stethoscope makes it possible to identify noises in the heart zone, indicating the dysfunction of the valves and the presence of the disease. An electrocardiogram is necessary to find abnormalities and abnormalities in the functioning of the heart, as evidenced by the increased amplitude and sharpening of the teeth.

A more accurate diagnosis of hypertrophy of the right atrium is echocardiography, which is performed with the help of ultrasound. The method gives an idea of the size and thickness of the walls of the cardiac chambers, helps to obtain a complete picture of the blood flow with the detailed state of the valves and tissues of the organ.

Characterize the magnitude of the atria and ventricles, as well as to identify pulmonary pathologies, which is especially important for congenital malformations, can be mediated by radiography.

[20], [21], [22], [23]

Hypertrophy of the right atrium on ECG

Excessive overload of the right atrium is expressed by the deviation of the electric axis to the right, forward and downward. Breast leads are normal - a two-phase tooth P in the positive phase displays excitation of the right atrium, and negative - of the left. The appearance of atrial hypertrophy on the right is characterized by an increase in the positive phase of the tooth, which is sharpened and increases in height.

Hypertrophy of the right atrium to the ecg is differentiated by a combination of symptoms, designated P-pulmonale and characteristic of pulmonary pathology, including chronic pulmonary heart and pulmonary hypertension, disorders of the small circulation. Hypertrophy of the right atrium is assessed by the following features: •

High amplitude of the tooth P and sharpening of the vertex with the lead I, III, aVF (value P more than 2.5mm); •

The first positive phase, which predominates over the negative, is determined by the high and pointed form of Pv1,2; •

The broadening or duration of the tooth P above 0.1 s.

If there are difficulties in differentiating hypertrophy, use the Macrus index - the ratio of the P value and the PQ segment. The pathology of the right atrium gives an index less than 1.1.

Treatment of right atrial hypertrophy

As is known, hypertrophy of the right atrium is a secondary problem. To bring the size of the atrium back to normal, to improve the supply of oxygen to the body due to the healthy functioning of the heart, possibly by therapy of the underlying cause. So, treatment of hypertrophy of the right atrium is based on an integrated approach to the treatment of underlying pathology. Physicians perform a medical correction of the condition, and the patient himself often needs a change in the habitual way of life. Without proper treatment of their own organism, the efforts of specialists can be futile. Rejection of addictions, reasonable restrictions in the daily diet (reducing salt, water, products with cholesterol, etc.), normalizing body weight, but at the same time, moderate physical stress. All of the above will accelerate the recovery and recovery processes, prevent the possibility of relapse.

In the diagnosis of the pulmonary heart, which is a consequence of lung problems, they work to compensate for pulmonary function with the use of anti-inflammatory measures, bronchodilators and other necessary medications. Valvular flaws in most situations require surgical treatment. To eliminate the symptoms of myocardial diseases, antiarrhythmic therapy, including cardiac glycosides and drugs that stimulate metabolic processes of muscle structures (for example, riboxin).

Timely diagnosed hypertrophy of the right atrium of the acquired character gives high chances for a full recovery and a long, full life.

Prevention of right atrial hypertrophy

Prevention of hypertrophy of the right atrium begins with a healthy lifestyle, a correct daily routine and a balanced diet. If your profession is not connected with professional sports, you should not exhaust yourself with physical exercises and enormous loads. To maintain an excellent mood and create a beautiful body shape, daily walks, swimming, cycling or moderate jogging are sufficient.

Today, more and more specialists are inclined to the fact that the body is difficult to tolerate extreme loads, which increase blood pressure and cause hypertrophy. The next colossal problem, beating on the heart muscle, is a nervous overstrain. Of course, you can not put yourself under a hood in a full vacuum, but you should do everything to prevent the wear of the heart. Maybe that's why the number of people, keen on yoga, meditation, relaxation practices, is growing steadily? Ability to think about good, to notice pleasant, to be inspired by the surrounding world becomes a necessary skill of every inhabitant of huge megacity.

Timely appeal to a doctor about diseases that can complicate the circulatory system, competent maintenance of health in the presence of congenital heart defects is no less important prevention of right atrial hypertrophy.

Prognosis of right atrial hypertrophy

Proceeding from the fact that hypertrophy of the right atrium is a consequence of a disease or vice, a favorable medical conclusion is based on successful treatment and features of the course of the primary pathology. A huge role is played by the degree of irreversible changes in the tissues and functioning of the heart. If the previous disease is congenital malformation, for example, stenosis of the pulmonary artery, leading to dilatation and hypertrophy first of the ventricle, and then the atrium to the right, surgery is required.

The defects of the acquired type, which are formed due to the transferred disease, are more often of an infectious nature, at the first stages are well suited for complex therapy. The prognosis of right atrial hypertrophy is largely determined by the severity of the defect, the presence of accompanying pathologies and the condition of the patient's body (for example, during pregnancy, the clinical picture may worsen), the severity of hemodynamic disorders.

Under the condition of early diagnosis, competent therapy and observance of all medical recommendations, right atrial hypertrophy is not considered a sentence for the patient. In this regard, it is very important to listen to the signals of your own body and in time to seek medical help.