Hypertrophy of the right ventricle

A heart. How many strokes in the whole human life it does, how much life-giving fluid, in the direct sense of the word, it pumps. But time comes and like any mechanism, it also begins to take over. Hypertrophy of the right ventricle (right ventricular myocardial hypertrophy) is a condition when the size of the right ventricle of the heart increases, the muscle tissue builds up, thereby increasing the load on the human blood pump itself-the heart.

As is known to each of the school course of anatomy, the human heart consists of four chambers. Two right valves with chambers are responsible in the human body for the normal functioning of the so-called small pulmonary circulation. The remaining left chambers pump blood plasma through a large systemic circle. Therefore, in a healthy person, the so-called pulmonary pressure is less than the venous pressure. When measuring blood pressure, it is characterized by a lower figure in the indications. This disease is manifested by the fact that the lower figure of the readings of the tonometer is increasing, the difference in pressure difference between the large and small circles shown by this apparatus is decreasing, which contributes to the deterioration of the general condition of the person and, subsequently, to the stable formation of the disease.

[1], [2], [3], [4], [5], [6], [7], [8]

Causes of right ventricular hypertrophy

This disease can not be called typical. It does not often occur, and it is sometimes difficult to recognize it. What are the causes of this disease?

The main causes of hypertrophy of the right ventricle are two. It:

• Mitral stenosis, which is characterized by a reduction in the area of the orifice that connects the right atrium and the ventricle of the same name. This hole closes the mitral valve.
• The pathology of the heart, formed in the womb of the mother.

That is, right ventricular hypertrophy develops on the basis of all sorts of deviations in the structure of the heart, often acquired at the stage of fetal formation, is in children, and in adults, any lung disease with complications that have affected the heart muscle or valve heart disease.

Depending on the degree of progression of the disease, its genesis, cardiologists classify hypertrophy of the right ventricle into several types:

• The tetrad of Fallot. This pathology manifests itself with the birth of a child. Her symptoms can be accompanied by a feline during the first year of life. Manifestations of this disease are also called "blue baby syndrome" - which are manifestations of dysfunction of blood outflow.
• Hypertension of pulmonary genesis. It is caused by increased pressure in the small pulmonary artery circle. In this regard, the patient acquires dyspnea, dizziness in combination with syncope.
• Stenosis valve small circulation ring. The manifestation of this pathology is a disruption in the flow of blood outflow into the blood vessel from the valve.
• Pathology of the interventricular septum. The defect in the structure of the cardiac septum allows two streams of neighboring sections to mix. This causes a decrease in the amount of oxygen transferred, 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, you can especially highlight:

• Inflammation of the lungs or pneumonia.
• Fibrosis. Conversely, the consolidation of the lung tissue, formed as a result of the transferred inflammatory process, or for any other reason.
• Bronchial asthma.
• Emphysema. This pathological expansion of the alveoli (pulmonary sacs) and respiratory tracts in contact with them.
• Chronical bronchitis.
• Pneumosclerosis. The proliferation of pulmonary tissue, which may be the result of the same inflammatory process.

[9], [10], [11], [12]

Signs of right ventricular hypertrophy

A large number of diseases have similar symptoms. And only a specialist (therapist, and in many cases only a narrowly focused doctor) is able to correctly analyze them and make a diagnosis. The considered deviation from the norm is able to diagnose only the cardiologist.

Such a disease as hypertrophy of the right ventricle can be attributed to fairly rare pathologies. Therefore, even with an electrocardiogram on hand, it is difficult to detect it, since the right ventricle's weight is less in percentage (it is about a third of the left mass), which allows the left, large, contour to predominate in the cardiogram readings.

Therefore, signs of hypertrophy of the right ventricle on the cardiogram are easy to read only with a significant increase in the mass component of the right ventricle.

Proceeding from the foregoing, medicine distinguishes such types of right ventricular hypertrophy:

• The case where the mass of the right region is substantially greater than the weight of the left ventricle is acute hypertrophy.
• A pathology of an average degree. Against the background of an increase in the parameters of the right heart, the exciting processes begin to flow more slowly.
• An easy degree of disease. The pathology of the right branch is insignificant.
• In the early stages of the disease (hypertrophy of the right ventricle), the symptomatology is poorly expressed, its manifestations are blurred. But in process of development of a pathology and gradual expansion of the sizes, the symptomatology becomes stable and recognizable:
• Suddenly, dizziness occurs, even to fainting states.
• Shortness of breath, making breathing difficult. Such attacks are usually accompanied by a pain syndrome in the chest area.
• Strong attacks of arrhythmia. Cardiopalmus.

Excellent visible swelling of the lower extremities.

Hypertrophy of the right ventricle in a child

The growth of the heart muscle increases the load on the right side of the kid's heart, which is much worse and more serious than with the same pathology of his left branch. The thing is that the pulmonary small circle of blood circulation, and, accordingly, the departments serving it, is adapted for normal work in the field of small pressures. If the discharge of blood fluid greater than prescribed, the volume of the left half of the heart or in the case of stenosis of the pulmonary artery, the pressure of the small circle increases, and the load on the right side of the heart muscle increases automatically. And to cope with increased loads, the right heart muscle of the heart muscle, nothing remains, how to build up mass, increasing in size. In this case, hypertrophy of the right ventricle in the child develops.

Monitoring the maximum number of cases of manifestation of the disease, led the doctors to the conclusion that this disease in children is much more common than in an adult. In a small man this disease can occur in the first days of his life and have a purely physiological character, since during this period the load on this half of the heart increases significantly. But these cases are quite rare. The greatest percentage of the disease of right ventricular hypertrophy still occurs in cases of congenital heart disease, the symptoms of which appear already in the first days of the child's life.

But not only the components of the heart, but also the vessels with the arteries that enter the pulmonary system are subjected to increased stress. And if the increased load persists for a sufficiently long time, the vessels become more rigid, which triggers the procedure of sclerosing the vessels. That, in turn, leads to a decrease in the plasma patency of the pulmonary ring, pressure in a small circle increases, leading to a disease that in medicine is called Eisenmenger syndrome. And the symptoms of this disease are irreversible. Drawing a conclusion from all the above, it is necessary to understand that hypertrophy of the right ventricle is serious and it is impossible to let the problem arise. In this situation, urgent medical intervention is necessary to prevent further unfavorable developments.

Therefore, if your child has found signs of this disease, do not fall into despair and do not panic. Just contact a cardiologist and go with your baby for a full medical examination.

Hypertrophy of the right ventricle in a newborn

Different age categories are subject to increase in volume and mass characteristics of the ventricle, but, nevertheless, the hypertrophy of the right ventricle in a newborn (the so-called congenital pathology - heart disease) is more frequent in percentage ratio than all other cases.

The cause of this disease in very young, newborn, children, cardiologists believe:

• increased stress, which affects the right heart region still in the womb or in the first days after birth.
• violation of the function of outflow of blood from the right ventricle, which leads to congenital pathology - right ventricular hypertrophy.
• can lead to abnormal changes in the blood supply system and the anatomical defect of the cardiac wall. That is, there is no sealed separation of one heart cavity from the other, which leads to a mixture of blood flow. In this case, blood is weakly saturated with oxygen, and, consequently, the human body as a whole receives less than it does, which leads to systemic pathology. And 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 moms should understand that in case of any symptoms deviating from the norm, do not despair and independently diagnose. It is better to contact your pediatrician as soon as possible, and the one, if necessary, will send to the pediatric cardiologists and this diagnosis can only be confirmed or denied by him. The sooner you contact your baby in the clinic, the faster and more gentle methods will treat your child.

Hypertrophy of the right and left ventricles

Hypertrophy of the right and left ventricles is, in some sense, a harbinger of a more severe disease caused by an increase in the myocardium. At the same time, it is a complex pathology caused by a significant increase in the muscle tissue of the heart, while the volume of the cavities of the ventricles remains unchanged.

Hypertrophy of the left myocardium. The work of the left ventricle ensures the functionality of a large circle of blood circulation. In case of a violation in his work, a person begins to feel:

• Pressing pain in the chest.
• Suddenly, dizziness appears.
• Often recurring fainting.
• The patient feels a decline of strength and apathy.
• A dream may break.
• Disturbances in the work of the human nervous system are traced.
• Appears arrhythmia.
• Dyspnea creates difficulty breathing. And it arises 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 a small circulatory cycle that has a normal working pressure lower than in the large contour. Therefore, with increasing pressure in it, the body suffers much more. Through blood vessels, a small blood supply cycle connects the work of the heart (right ventricle) to the lungs, so any problems that arise with the lungs immediately affect the heart muscle, leading to hypertrophy of the right ventricle.

Diagnosis of right ventricular hypertrophy

Diagnosis of any disease should be made by the doctor after the whole complex of studies. Diagnosis of right ventricular hypertrophy includes:

• Physical examination - examination of the doctor. Often it is he who pushes the idea of a disease. A competent cardiologist is able to hear noises in the heart and malfunctions in the working rhythm.
• Electrocardiography. But with the help of a cardiogram you can see only the rhythm disturbance, but not the violation of the dimensions. That is, it is an indirect diagnosis.
• Analysis of patient complaints.
• Echocardiography. This technique with the help of ultrasound makes it possible to determine the parameters of the heart muscle, measure its thickness, detect a violation of outflow of blood through defects, and estimate their sizes. It makes it possible to measure the pressure in the ventricle. A fairly accurate method of determination.
• ECG.
• Cardiovisor. This device allows you to observe the dynamics of the heart. They can be used at home.
• Identification of hereditary predisposition to the disease.
• The risk group also includes people who are overweight, or, on the contrary, athletes who receive heavy workloads in training and competitions, as well as owners of bad habits. They need to periodically undergo prophylactic examinations at the cardiologist.

[13], [14], [15],

Hypertrophy of the right ventricle on the ECG

Of course, specialists with medical education can and should read and decode the electrocardiogram, but they are especially curious to expand their horizons, they can try to understand the physiological, impulse, processes that occur in the myocardium with hypertrophy of the right ventricle.

So let's try to figure out what kind of change shows the right ventricular hypertrophy on the ecg. Primarily it is worthwhile to understand that the mass component of the right ventricle is three times smaller than the mass of the left and, in the normal state, the electrical impulses, which radiate the half that interests us, are much lower. Therefore, in a healthy state the signal from the left, "stronger" ventricle prevails. In a state of hypertrophy, the right ventricle begins to produce a stronger EMF, which shifts the total vector to the right.

In the light of these calculations, cardiologists distinguish three varieties of hypertrophy of the right ventricle:

• Severe degree of hypertrophy. This variety is characterized by the fact that the size of the right ventricle begins to exceed the corresponding parameters of the left ventricle.
• The average degree of hypertrophy. In this case, the hypertrophy of the right region already exists, but the parameters are still smaller, the size of the left ventricle. The emf of the right ventricle increases, but it is still weaker than the impulses that go from the left.
• Light hypertrophy. Deviation from the right ventricle is present, but it is still insignificant.

Let's try to understand the symbols that occur in the cardiogram:

• The symbol P denotes the teeth that are responsible for the contraction of the atria.
• The letters Q, R, and S denote the characteristics of ventricular contraction.
• T is a characteristic of a relaxing signal in the ventricles of the heart.

Now let's understand, in what cases the cardiologist can make a diagnosis - right ventricular hypertrophy.

• If the electrocardiogram shows sufficiently high RV1, V2 teeth, with abnormalities in the outbursts of the tooth TV1, V2. And the segment STV1, V2 is not observed.
• If, during cardiac work in the load, the electrocardiogram displays high bursts of RV1, V2, while the pulsation of segment STV1, V2 is reduced, and the tooth amplitude T V1, V2. Has a negative value.
• The cardiologist ascertains the presence of hypertrophy of the right ventricle with obvious signs of myocardial pathology and its increased overload in the event that the combination of a high ridge R with a reduced segment of the ST, as well as negative T indices are seen not only in the regions V1, V2, but also in other zones of the heart .

But it is worth noting that the ECG does not clearly show hypertrophy of the right ventricle, in contrast to left ventricular hypertrophy. Therefore, before you make a final diagnosis, you need to turn to other diagnostic methods.

Treatment of right ventricular hypertrophy

Most often, hypertrophy of the right ventricle affects patients who have a history of chronic lung diseases, as well as heart disease acquired in the womb and so on. Treatment begins after the diagnosis is made and the origins of pathology are established.

Depending on the causes of the changes in the right ventricular myocardium and use the technique, which is used to treat right ventricular hypertrophy.

• The etiotropic method of treatment is used in case of an identified congenital heart disease. This method is aimed at eliminating or weakening the effect of the very cause that activates the disease.
• The pathogenetic method is used with the "acquired" hypertrophy of the right ventricle. The method works to increase passive and active immune processes that block the cause of the disease.

Both of these techniques work to bring blood pressure back to normal, slow the progression of the disease and, if possible, correct the defect. And as treatment should be aimed at eliminating the immediate cause of the disease: whether it is chronic lung disease, congenital heart disease or stenosis of the pulmonary canal.

If hypertrophy of the right ventricle causes heart disease, the patient will be shown surgical intervention. Typically, this applies to young children. In this case, the operation is attempted in the first year of the child's life.

With a pulmonary cause of the disease, the doctor attributes the patient bronchodilators, respiratory analeptics, mucalcides. Such as:

Broncholitin (bronchodilator). This drug is attributed to an adult patient at a rate of one tablespoon for three to four meals a day.

For children over the age of ten, the dosage is somewhat smaller and amounts to a dose - a tablespoon (or two teaspoons) three times a day.

To children from three to ten years, a one-time dose of intake will be one teaspoon three times a day.

This drug is not recommended for people suffering from angina pectoris, insomnia, glaucoma, heart failure, thyrotoxicosis and some other diseases. Do not give broncholitin and babies to three years, as well as future mothers in the first trimester of pregnancy and during breastfeeding.

Analeptic (respiratory analeptics). Such drugs are used relatively rarely, but with newborn asphyxiation this medicine helps the baby to restore normal breathing. The karapuza is placed in a warm bath (38-39 ° C). Slime is sucked off from the baby's spout with a special can. Prepare a solution of 1ml of the drug and 5ml of saline (it can be replaced with 5% glucose). Analeptic is given to the baby through the vein very slowly. If no apparent result is observed, then the medical device is reintroduced.

Analeptic can not be administered to a patient with epilepsy, convulsions, tetanus.

Bromhexine (mucaltic agents). In the tablets toddlers until the age of six this drug is not given. Children six to ten years of age give 8 mg of the drug three times a day. During the intake of bromhexine, a large amount of liquid must be consumed.

Karapuzam up to two years, the drug is given in the form of a syrup of 0.5 teaspoon. Babies from two to six years are better to give a drug of 0.5 - 1 teaspoon in the form of syrup. For children older (from six to 14 years) - 1 - 2 teaspoons.

To correct the arterial pressure of the patient with hypertrophy of the right ventricle, the cardiologist can attribute:

Euphyllinum. Dosage is set by the doctor individually. Adults at a rate of 0.15 g with a single admission. Such receptions can be from one to three per day.

For children, the method is stretched into three approaches. The daily dosage is 7 to 10 mg per kilogram of the child's weight. If no apparent effect is observed, the dosage can be increased until a positive result is obtained. But it is necessary to raise the dose gradually, step by step, in two to three days. The therapeutic course is set by the doctor, and it can range from a couple of days to several months.

Eufillin is contraindicated in persons who are hypersensitive to the constituent components of the drug, with arrhythmia, if the patient has a history of peptic ulcer disease, heart failure, myocardial infarction and many others.

With a mild stage of right ventricular hypertrophy, the cardiologist may attribute:

Nifedipine. The drug is administered two to three times a day at a dosage of 0.01 g. Dosage can be increased to 0.02 g. In very rare cases, the patient can receive 20 mg of the drug (0.02 g) four times during the day, but the total daily dosage should not exceed 80 mg. The duration of the course is individual and is prescribed by the doctor based on the clinical picture of the disease and the condition of the patient himself.

This drug can not be taken with hypotension, acute heart failure, collapse, during pregnancy and lactation, as well as in some other diseases.

If the disease occurs in a decompensated regimen, the patient receives medicines from a group of nitrates, for example, such as nitrosorbide or nitroglycerin. Drugs are taken under monitoring of blood gas composition.

Nitrosorbide. An adult patient is prescribed a dosage of 5 to 10 mg of the drug half an hour before a meal, three to four times a day. With severe manifestations of the disease, the dosage can be increased to 20 - 30 mg. If a patient has severe heart failure, he must drink 20 mg (two tablets) every four to five hours.

This drug is not prescribed for strokes, craniocerebral trauma, individual intolerance to nitrates, with glaucoma and increased eye pressure, and so on.

Nitroglycerine. If the drug is taken in the form of tablets, then, before dissolving, put under the tongue. Applied for rapid relief of acute pain. Nitroglycerin is prescribed in a dosage - one - two tablets (0.5 - 1 mg). But the total daily amount of medicine should not exceed 6 tablets.

Nitroglycerin in the form of capsules consume the same. To accelerate the expected result, the capsule must be split in the mouth with teeth. Quantitative administration of the drug depends on the frequency of painful attacks. The withdrawal of symptoms of angina and relief usually comes quickly, after ½ - 2 minutes after taking the medication. If there is no effect, then after five minutes you need to take another pill. If there is no therapeutic result and after two to three tablets, emergency ambulance should be called.

The list of contraindications is large enough. This: and individual intolerance of nitrates, recently suffered head trauma, acute period of myocardial infarction, toxic pulmonary edema, arterial hypotension, pathology of the blood circulation of the brain, collapse and many other diseases. A complete list of contraindications can be viewed in the instructions attached to the medication. Doctors do not attribute nitroglycerin to children and adolescents under the age of 18, as well as mothers during pregnancy or lactation.

Throughout the duration of the treatment, the doctor must control the work of the heart. And the patient at this time will have to completely give up smoking and drinking alcohol. In this case, the patient must comply with the regime of the day and nutrition. Useful exercise will be physical exercise and swimming.

Prevention of right ventricular hypertrophy

Every sane person should understand that in order not to get the disease in any of its manifestations, it is necessary first of all to prevent or eliminate the cause of its occurrence. So prevention of right ventricular hypertrophy reduces:

Carrying out of the actions promoting prevention of phlebothrombosis progression of legs:

• Diagnosis of this pathology in the early stages and immediate treatment.
• This is a preventive examination of hospital patients for increased risk of manifestations of right ventricular hypertrophy.
• The postoperative patient with the diagnosis of phlebotrombosis of the legs should actively move (the blood should not "stagnate"), tie up the operated leg with an elastic bandage. Perform the entire treatment protocol, appointed by the attending physician.

In chronic lung diseases:

• It is necessary to protect yourself from hypothermia and drafts.
• Refuse to smoke, avoid even passive smoke consumption.
• Do not run the disease, but try to take action even in the early stages of its manifestation.
• To lead an active life with moderate loads.
• A good preventive tool can be oxygen cocktails.

Prognosis of right ventricular hypertrophy

Until recently, the chronic pulmonary heart was considered an irreversible disease. Modern medicine classifies it as a reversible complication. Therefore, the prognosis of right ventricular hypertrophy, to date, largely depends on the patient's anamnesis, the nature and severity of the disease, which was the cause and the impetus to the development of right ventricular hypertrophy. The most unpleasant prognosis is obtained by patients with frequently recurring manifestations of thromboembolism of small pulmonary arteries, as well as patients diagnosed with pulmonary hypertension of the primary stage. If the disease of such patients could not be stopped, their life expectancy is no more than 2.5-5 years. So according to statistics, patients with a diagnosis of chronic right ventricular hypertrophy, with obstructive diseases of pulmonary genesis, leave their life before, not reaching the average age. At the time of death, the average age of men was 59 years.

Therefore, a lot depends on how early the pathology is diagnosed and diagnosed, as well as on how timely and effective treatment will begin.

Our heart is the motor of our body. And if it starts to fail, the entire organism is unbalanced. If the mechanism is constantly prophylactically examined, maintained, groomed and cherished, then it will be able to work without fail for a long time. So is our body. If right ventricular hypertrophy is recognized at an early stage of development, then this process is not only possible to stop, but also to reverse. Timely treatment of other diseases, will simply prevent the emergence and development of this pathology. If the pathology is congenital, do not give up medical assistance.

Therefore, do not let even a trivial cold catch yourself, and at the first signs of the disease, contact the specialists. Good luck and take care of yourself.