A pathologically strengthened heart muscle of the right ventricle is referred to as right heart hypertrophy. While limited strengthening of the heart muscle during cardiovascular training leads to an increase in cardiac performance, cardiac muscle performance decreases again in the event of hypertrophy of the heart muscle due to the increasing stiffness of the affected walls. In the case of right heart hypertrophy, the pulmonary circulation, also known as the small blood circulation, is affected.
What is right ventricular hypertrophy?
To a certain extent, strengthening the heart muscle of the entire heart, which can be achieved through cardiovascular training, leads to an increase in performance. Hypertrophy of the right or left heart only occurs when the stimulus to growth of the heart muscle in the right or left ventricle persists. Right ventricular hypertrophy is manifested by a pathological increase in muscle tissue of the right ventricle. For what is bipolar disorder, please visit beautyphoon.com.
The heart wall in the area of the right ventricle is very thick and interspersed with fibrous tissue. As a result, the heart muscle becomes inelastic and the capillary blood supply cannot quite keep up with the greater need for oxygen, so that the supply of oxygen to the smooth muscle cells of the heart muscle is also reduced. In the case of right ventricular hypertrophy, the increasing rigidity of the heart muscle in connection with the lack of oxygen supply leads to a reduction in the heart’s performance.
The impaired ejection capacity of the right ventricle initially affects the pulmonary circulation, also known as the lesser blood circulation, because the blood from the right ventricle is pumped into the pulmonary artery via the open pulmonary valve during contraction (systole).
Causes
The most common cause of right ventricular hypertrophy is left ventricular failure. A reduced ejection capacity of the left ventricle, which pumps the blood through the aortic valve into the large circulatory system or systemic circulation during systole, causes a backlog in the pulmonary circulation. The resulting increased pressure in the pulmonary artery triggers the stimulus in the right ventricle to increase pumping capacity.
However, since this does not solve the problem of backflow, the incentive of the right ventricle to increase performance remains and gradual hypertrophication sets in. Right ventricular hypertrophy can also be caused by partial obstruction of the lungs. Pulmonary emphysema, tuberculosis, or diffuse pulmonary fibrosis can obstruct part of the pulmonary vascular system. This leads to an increase in vascular resistance in the pulmonary artery, known as pulmonary arterial hypertension.
Similar to the congestion caused by left heart failure, the right ventricle initially responds with increased output, but this does not solve the problem. Therefore, hypertrophication gradually develops. Other causes can be pulmonary valve stenosis or a ventricular septal defect. In both cases, the right ventricle “tries” to compensate for the reduced supply to the aorta during systole by increasing its output, which then gradually triggers hypertrophy.
A very rare cause is tetralogy of Fallot, a genetic abnormal development of the heart. It manifests itself in four defects that occur simultaneously: narrowing of the entrance to the pulmonary artery – comparable to pulmonary stenosis, incomplete closure of the cardiac septum between the two chambers, displaced aortic entrance and the resulting hypertrophy. Prolonged exposure to extreme altitudes can also lead to right ventricular hypertrophy.
Symptoms, Ailments & Signs
The onset of right ventricular hypertrophy initially has no symptoms or complaints. Only when the ejection capacity of the right ventricle decreases (diastolic dysfunction) do the first signs of shortness of breath appear during physical exertion. Unspecific, general tiredness and lethargy usually make themselves felt beforehand, which can be traced back to the chronic lack of oxygen supply (hypoxia).
Blood congestion can occur in the digestive tract, leading to impaired digestion and a reduced ability to absorb nutrients in the small intestine. Impairments of certain liver functions can also occur. Externally visible signs are a greenish-blue discoloration of skin and mucous membranes (cyanosis). In some cases accumulations of tissue fluid (oedema) form and congestion occurs in the neck veins.
Diagnosis & course of disease
Right heart hypertrophy can be detected by means of an ultrasound examination (echocardiography). The ECG also allows conclusions to be drawn about the function of the heart. If necessary, magnetic resonance imaging (MRI) provides further findings and insights into the progress or severity of the disease. In more advanced stages, there is chest pain comparable to that of angina pectoris.
Right ventricular hypertrophy can also trigger a cardiac arrhythmia or even cause a heart attack. The course of the disease increases in severity unless the cause of the hypertrophy is found and treated.
Complications
Right ventricular hypertrophy is initially symptom-free, but is always accompanied by late effects. In the course of the disease, shortness of breath develops, which occurs mainly during physical exertion and significantly restricts the patient’s everyday life. The fatigue that typically occurs develops into physical exhaustion, which is also associated with limitations in everyday life and professional life.
Occasionally, blood congestion occurs in the digestive tract, which results in impaired digestion and a reduced ability to absorb nutrients in the small intestine. In the long term, the liver functions are often impaired, which is accompanied by edema, cyanosis and other symptoms. Diuretics, which can cause side effects under certain circumstances, are usually used in the treatment.
Symptoms may include dizziness, headache, muscle spasms, and a rash. In individual cases, the drug promotes joint diseases such as gout, impotence and menstrual cramps. If the right ventricular hypertrophy is treated surgically, i.e. an artificial heart valve is used, this always represents a great burden for the organism.
Possible complications include atrial fibrillation, bleeding, infection, stroke, and temporary psychological discomfort. Undetected previous illnesses can also lead to heart failure.
When should you go to the doctor?
Right ventricular hypertrophy should always be treated by a doctor. In the worst case, this disease can lead to the death of the person affected if the right ventricular hypertrophy is not treated in time. The doctor should be consulted if severe breathing difficulties occur. These can occur above all in strenuous or stressful situations and have a very negative effect on the patient’s quality of life. Furthermore, severe shortness of breath also indicates right ventricular hypertrophy and should be examined.
Severe tiredness can also be a sign of the disease. Patients often also suffer from restricted digestion and cannot absorb food and liquids without discomfort. In severe cases, right ventricular hypertrophy can also lead to cyanosis. In this case, an ambulance should be called immediately or you should go straight to the hospital. In general, right ventricular hypertrophy is treated by a cardiologist. However, an operation may also be necessary.
Treatment & Therapy
The focus of treatment and therapy for right ventricular hypertrophy is the treatment of the anomaly or disease that caused the hypertrophy. In many cases, this means that the increased pulmonary pressure must be reduced in order to deprive the right ventricle of the incentive to compensate for the insufficient blood flow in the pulmonary artery.
Diuretics can aid in the process because, in the case of edema or pulmonary emphysema, they help to flush out the accumulated tissue fluid via the kidneys in order to reduce central venous pressure. In other cases where there is mitral or pulmonary valve insufficiency, implantation of an artificial heart valve can solve the problem.
Prevention
Preventive measures to prevent right ventricular hypertrophy can always only be based on the prevention or prevention of disease states that have right ventricular hypertrophy as secondary damage in their luggage. This means that the occurrence of unspecific symptoms such as chronic fatigue, lack of physical fitness and frequent blue discoloration of the lips and extremities should be clarified.
If no clear cause or explanation for the symptoms can be found, a cardiological clarification using an ECG and echocardiography is also recommended in order to be able to take countermeasures as early as possible – if possible before the hypertrophy manifests itself.
Aftercare
In most cases, those affected with right ventricular hypertrophy have only limited follow-up measures available, since this is a rare disease. If the disease has been present since birth, it can usually not be completely cured. Therefore, if the person concerned wants to have children, they should have a genetic examination and counseling carried out in order to prevent the disease from reoccurring.
As a rule, no independent healing can occur. Most of those affected are dependent on taking various medications, whereby it is always important to ensure the correct dosage and regular intake. If you have any questions or are unclear, you should always contact a doctor first, and you should also consult a doctor if you have any side effects.
Regular check-ups by a doctor are also very important. If the disease is treated by surgery, the person concerned should take it easy after the procedure and protect the affected region in particular. This can prevent infection and inflammation. In many cases, right ventricular hypertrophy also limits the life expectancy of those affected, although a general course cannot be predicted.
You can do that yourself
Patients with right ventricular hypertrophy should pay attention to the signs of their organism. In the case of physical exertion or situations of overload, rapid tiredness and rapid exhaustion occur. The person concerned should take breaks and completely avoid the onset of severe stress. Intense sporting activities should not be practiced.
Leisure activities are to be adapted to the possibilities of the organism. Stress or emotional disruptive factors must be eliminated at an early stage. It is helpful to practice relaxation techniques such as yoga or meditation. In addition, mental training sessions help to strengthen the mind. Conflicts with other people should be resolved as quickly as possible and should not be intensified. Cognitive techniques help to change one’s own behavior and to avoid situations of confrontation with other people. In professional life, it is important to ensure that neither physical nor mental limits are exceeded.
In everyday life, the patient has to learn to react to his own physical signals. The development of positive stimuli is important for promoting well-being and quality of life. Hobbies and leisure activities should be geared towards strengthening the zest for life. This reduces stress and supports health.
In addition, it must be ensured that the body’s own weight is within the normal range of the BMI. Any overweight should be reduced by changing and optimizing the food intake.
