Right Ventricular Hypertrophy

Aka: Right Ventricular Hypertrophy, Right Ventricular Enlargement, Right Ventricular Hypertrophy Related EKG Changes

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II. Pathophysiology

  1. Increased right ventricular muscle mass in response to increased right sided pressures

III. Findings

  1. See Pulmonary Hypertension

IV. Causes

  1. Pulmonary Hypertension
  2. Significant tricuspid regurgitation

V. Diagnostics: Electrocardiogram (EKG)

  1. Reversal of precordial pattern
    1. Tall R in V1 and V2 (R >6 mm in V1)
    2. Deep S in V5 and V6
    3. Total Rv1 + Sv6 (or Sv5) > 10.5 mm
  2. Late Intrinsicoid Deflection in V1 and V2 (V1 deflection > 0.035 seconds)
  3. Right Axis Deviation (>90 degrees)
  4. Normal QRS Duration
  5. Incomplete Right Bundle Branch Block
  6. ST segment Depression in inferior leads (strain pattern)
    1. Upward convexity
  7. Inverted T Waves in V1 and V2
  8. Right atrial hypertrophy (P Pulmonale)

VI. Diagnostics: Echocardiogram

  1. Evaluate Tricuspid Valve for tricuspid regurgitation
  2. Evaluate Right chamber sizes and right ventricular function
  3. Estimate pulmonary artery systolic pressure
  4. Evaluate for concurrent left heart disease

VII. Management

  1. See Pulmonary Hypertension
  2. See Tricuspid Regurgitation

VIII. References

  1. Bhattacharya (2021) StatPearls, accessed 2/23/2021
    1. https://www.ncbi.nlm.nih.gov/books/NBK499876/

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Related Studies

Ontology: Right Ventricular Hypertrophy (C0162770)

Definition (MSHCZE) Zvětšení pravé komory srdeční. Nárůst ventrikulární hmotnosti lze přičíst HYPERTENZI PLICNÍ a to bývá často jednou z příčin kardiovaskulární morbidity a mortality. R
Definition (NCI_FDA) Enlargement or overgrowth of the myocardium of the right ventricle, due chronic pressure overload.
Definition (NCI) Enlargement or overgrowth of the myocardium of the right ventricle, due chronic pressure overload.
Definition (MSH) Enlargement of the RIGHT VENTRICLE of the heart. This increase in ventricular mass is often attributed to PULMONARY HYPERTENSION and is a contributor to cardiovascular morbidity and mortality.
Concepts Disease or Syndrome (T047)
MSH D017380
SnomedCT 290931000009103, 89792004, 308521000009101
English Ventricular Hypertrophy, Right, Hypertrophy, Right Ventricular, Hypertrophies, Right Ventricular, Right Ventricular Hypertrophies, Ventricular Hypertrophies, Right, RVH - Right ventr hypertrophy, Right Ventricular Hypertrophy, RVH, right ventricular hypertrophy, right ventricular enlargement, hypertrophy of right ventricle (diagnosis), hypertrophy of right ventricle, right ventricular enlargement (diagnosis), Hypertrophy, Right Ventricular [Disease/Finding], hypertrophy right ventricular, rvh, Hypertrophy;ventricular;right, enlargement right ventricular, Enlarged right ventricle, Cardiomegaly of right ventricle, Right ventricular enlargement, Right ventricle hypertrophied, Enlarged right ventricle (finding), Cardiomegaly of right ventricle (disorder), RIGHT VENTRICULAR HYPERTROPHY, HYPERTROPHY, RIGHT VENTRICULAR, VENTRICULAR HYPERTROPHY, RIGHT, RV hypertrophy, RVH - Right ventricular hypertrophy, Right ventricular hypertrophy, Right ventricular hypertrophy (disorder)
Dutch rechterventrikelvergroting, rechterventrikelhypertrofie, Hypertrofie, rechterventrikel-, Rechterventrikelhypertrofie, Ventrikelhypertrofie, rechter-
French Augmentation de taille du ventricule droit, HVD, Hypertrophie ventriculaire droite, HVD (Hypertrophie Ventriculaire Droite)
Italian Ingrandimento ventricolare destro, Ipertrofia ventricolare destra, Ipertrofia del ventricolo destro
Portuguese Aumento do ventrículo direito, Hipertrofia do ventrículo direito, Hipertrofia Ventricular Direita
Spanish Aumento del ventrículo derecho, HVD, Hipertrofia ventricular derecha, hipertrofia del ventrículo derecho, hipertrofia ventricular derecha (trastorno), hipertrofia ventricular derecha, Hipertrofia Ventricular Derecha
Japanese 右室拡大, ｳｼﾂｶｸﾀﾞｲ, ｳｼﾂﾋﾀﾞｲ, RVH, ＲＶＨ, 右室肥大, 右心室肥大, 肥大右室, 肥大右心室
Swedish Hjärtkammarförstoring, högersidig
German Rechtsherzhypertrophie, RVH, Vergroesserung des rechten Ventrikels, Hypertrophie, rechtsventrikuläre, Rechtsventrikuläre Hypertrophie, Ventrikuläre Hypertrophie, Rechts-
Czech srdce - hypertrofie pravé komory, Hypertrofie pravé komory, Zvětšení pravé komory, hypertrofie pravé komory srdeční, hypertrofie pravé srdeční komory
Finnish Oikean kammion hypertrofia
Russian PRAVOZHELUDOCHKOVAIA GIPERTROFIIA, SERDTSA PRAVOGO ZHELUDOCHKA GIPERTROFIIA, GIPERTROFIIA PRAVOGO ZHELUDOCHKA SERDTSA, SERDTSA ZHELUDOCHKA PRAVOGO GIPERTROFIIA, PRAVOGO ZHELUDOCHKA GIPERTROFIIA, ГИПЕРТРОФИЯ ПРАВОГО ЖЕЛУДОЧКА СЕРДЦА, ПРАВОГО ЖЕЛУДОЧКА ГИПЕРТРОФИЯ, ПРАВОЖЕЛУДОЧКОВАЯ ГИПЕРТРОФИЯ, СЕРДЦА ЖЕЛУДОЧКА ПРАВОГО ГИПЕРТРОФИЯ, СЕРДЦА ПРАВОГО ЖЕЛУДОЧКА ГИПЕРТРОФИЯ
Croatian HIPERTROFIJA DESNE KLIJETKE
Polish Przerost komory serca prawej, Przerost prawej komory
Hungarian Jobb kamra hypertrophia, Jobb ventricularis megnagyobbodás, RVH
Norwegian Høyre ventrikkel-hypertrofi, Hypertrofi, høyre ventrikkel, Ventrikkelhypertrofi, høyre
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Electrocardiogram: right ventricle hypertrophy (finding) (C0232305)

Definition (NCI) An electrocardiographic finding suggestive of a hypertrophied right ventricle, characterized by large R wave amplitudes in the right precordial leads and secondary findings of right atrial enlargement, right axis deviation, and typical pattern of ST depression and T wave inversion in the right precordial leads. (CDISC)
Definition (NCI_CDISC) An electrocardiographic finding suggestive of a hypertrophied right ventricle, characterized by large R wave amplitudes in the right precordial leads and secondary findings of right atrial enlargement, right axis deviation, and typical pattern of ST depression and T wave inversion in the right precordial leads.
Concepts Laboratory or Test Result (T034)
SnomedCT 164880004, 164877000, 89596004, 142037001, 142040001
English ECG: RVH NOS, Ekg Right Ventricular Hypertrophy, ECG: right ventricle hypertrophy (finding), ECG: right ventricle hypertrophy, Electrocardiogram: right ventricle hypertrophy, ECG: RVH - right ventricle hypertrophy, ECG right ventricular hypertrophy, right ventricular hypertrophy, Electrocardiogram: right ventricle hypertrophy (finding), electrocardiogram: right ventricular hypertrophy, electrocardiogram: right ventricular hypertrophy (procedure), Right Ventricular Hypertrophy by ECG Finding, Right ventricular hypertrophy by EKG, RVH by EKG, ECG:right ventricle hypertrop. (finding), Right ventricular hypertrophy by EKG (finding), Electrocardiogram: right ventricle hypertrophy NOS (finding), Electrocardiogram: right ventricle hypertrophy NOS, ECG: RVH NOS (finding), Right Ventricular Hypertrophy by EKG Finding, Right ventricular Hypertrophy, RIGHT VENTRICULAR HYPERTROPHY, ECG:right ventricle hypertrop.
Spanish ECG: HVD, ECG: hipertrofia del ventrículo derecho, signos electrocardiográficos de hipertrofia del ventrículo derecho, ECG con signos de HVD, ECG: RVH NOS, electrocardiograma: hipertrofia ventricular derecha, SAI (hallazgo), signos electrocardiográficos de hipertrofia ventricular derecha, ECG: HVD, SAI, signos electrocardiográficos de hipertrofia ventricular derecha (hallazgo), electrocardiograma: hipertrofia ventricular derecha, SAI, ECG: hipertrofia ventricular derecha, SAI, ECG: hipertrofia ventricular derecha, electrocardiograma: hipertrofia ventricular derecha (hallazgo), electrocardiograma: hipertrofia ventricular derecha
Derived from the NIH UMLS (Unified Medical Language System)

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