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Right Ventricular Hypertrophy

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

  • See Also
  1. Pulmonary Hypertension
  2. Tricuspid Regurgitation
  3. Left Ventricular Hypertrophy
  • Pathophysiology
  1. Increased right ventricular Muscle mass in response to increased right sided pressures
  • Findings
  1. See Pulmonary Hypertension
  • Causes
  1. Pulmonary Hypertension
  2. Significant tricuspid regurgitation
  1. Reversal of precordial pattern
    1. Tall R in V1 and V2 (R >=7 mm in V1) or qR pattern in lead 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)
  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
  • Management
  1. See Pulmonary Hypertension
  2. See Tricuspid Regurgitation
  • References
  1. Bhattacharya (2021) StatPearls, accessed 2/23/2021
    1. https://www.ncbi.nlm.nih.gov/books/NBK499876/