What Is Right Ventricular Hypertrophy?

The right ventricle is one of the two lower chambers of the heart. It receives deoxygenated blood (blood in which oxygen has been removed) from the body and then pumps this blood to the lungs to receive oxygen. Right ventricular hypertrophy, also known as right ventricular enlargement, is a thickening of the heart’s right lower chamber wall when there is pressure overload due to lung disease.

As the muscle thickens, it becomes more difficult for the heart to pump blood to the lungs. It usually is caused by severe lung disease but can also be caused by a leaky left-sided heart valve (aortic regurgitation) or other heart conditions. Symptoms, diagnosis, and treatment depend on underlying conditions and their severity.

This article explains right ventricular hypertrophy's symptoms, causes, diagnosis, and treatment.

Right Ventricular Hypertrophy Symptoms

Right ventricular hypertrophy itself may have no symptoms. However, symptoms can come from the lung conditions or heart problems associated with it. These symptoms include:

• Chest pain
• Shortness of breath
• Peripheral edema (swelling of the legs, feet, or ankles)
• Dizziness or fainting after exercise
• Pain in the upper right abdomen

Less common symptoms include a cough, hoarseness, or coughing up blood.

Causes

Right ventricular hypertrophy is most commonly caused by pulmonary hypertension (blood pressure leading from the heart to the lungs is too high). Pulmonary hypertension occurs when the arteries in the lungs narrow, causing decreased blood flow.

High blood pressure in the lungs has several causes, including:

• Left-sided heart disease (inability to pump blood)
• Lung conditions such as COPD (chronic obstructive pulmonary disease)
• Liver disease
• Congenital heart defects (heart problems present at birth)

Tricuspid regurgitation, a leaky tricuspid heart valve, can also cause right ventricular hypertrophy. Causes of tricuspid regurgitation include:

• Heart disease
• Pulmonary hypertension
• Infection
• Chest trauma
• Marfan syndrome (a genetic disease affecting connective tissue that can cause heart problems)
• Congenital heart disease

Congenital heart defects that affect the right side of the heart can also cause right ventricular hypertrophy.

Diagnosis

It's important for healthcare providers to determine what diseases or structural defects led to the development of right ventricular hypertrophy in patients. Diagnostic tests for right ventricular hypertrophy depend on what your provider suspects is causing it.

Certain tests also help providers determine if symptoms are coming from other conditions such as left-sided heart failure or coronary artery disease.

Tests used to evaluate right ventricular hypertrophy include:

• Physical exam
• Chest X-ray
• Echocardiogram
• Electrocardiogram (ECG)
• Cardiac stress test
• Cardiac catheterization
• Cardiac magnetic resonance imaging (MRI)

Treatment

Treatments focus on treating the underlying cause of right ventricular hypertrophy. They include:

• Diuretics (water pills)
• Anticoagulants (blood-thinning medication)
• ACE (angiotensin-converting enzyme) inhibitors
• Oxygen therapy
• Beta-blockers
• Tricuspid valve surgery (for patients with severe tricuspid regurgitation)

Prognosis

Prognosis of right ventricular hypertrophy depends on both the severity as well as the underlying cause. In recent years, medicine has made great advancements in the management of right-sided heart disease.

If right ventricular hypertrophy isn’t addressed, it can lead to right-sided heart failure, although precisely how this happens is not well understood.

Lifestyle changes can help slow the progress and manage symptoms of right-sided heart failure and pulmonary hypertension. These lifestyle changes include:

• Quitting smoking
• Exercising
• Eating a healthful diet
• Avoiding caffeine and alcohol
• Getting enough sleep
  

Coping

Many people with heart disease lead productive lives. Some of the keys to living a good life with heart disease include maintaining your treatments and medical follow-ups and taking care of your physical and mental health.

Summary

Right ventricular hypertrophy is a thickening of the heart’s lower right chamber due to pressure overload. This makes it harder for the heart to pump blood to the lungs.

The most common causes of right ventricular hypertrophy are severe lung disease, a leaky tricuspid heart valve, or certain genetic heart conditions. Diagnosis and treatment depend on the underlying conditions causing right ventricular hypertrophy.

A Word From Verywell

If you are suffering from right ventricular hypertrophy, it’s important that your healthcare provider determines what led to it. Your treatments will focus on controlling these underlying conditions and preventing them from progressing. Making healthy lifestyle changes can improve your heart, lungs, and overall health.