Right Ventricular Hypertrophy.


Right Ventricular Hypertrophy is an increase in the thickness of the walls of the right ventricle. The right ventricle is three times thinner than the left ventricle, thus frequently hypertrophy of the right ventricle may be unrecognized.


Causes:

  • Pulmonary hypertension
  • Congenital heart disease (e.g. Tetralogy of Fallot, pulmonary stenosis, Ventricular septal defect (VSD))
  • Pulmonic regurgitation
  • Chronic obstructive pulmonary disease (cor pulmonale)
  • Athletic heart syndrome
  • Mitral stenosis
  • Arrhythmogenic right ventricular cardiomyopathy


Examples of Right Ventricular Hypertrophy:





ECG criteria:

  1. Right axis deviation (>90 degrees)
  2. Criterion for recognition, suggested by Davis (1985):
    • R wave is greater than or equal to S wave in V1;
or

    • R wave in V1 + S wave in V6 is greater than or equal to 10 mm;

   3. Right ventricular strain pattern: ST depression and T wave inversion in V1-V4.




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