Understanding Right Ventricular Hypertrophy

Medically reviewed by Carissa Stephens, RN, CCRN, CPN on February 9, 2018Written by Rachel Nall, RN, BSN, CCRN on February 9, 2018

What is right ventricular hypertrophy?

Your heart is divided into a left and a right side. The right side of your heart pumps blood to your lungs to receive oxygen. The left side pumps the oxygenated blood to the rest of your body.

Right ventricular hypertrophy (also called right ventricular enlargement) happens when the muscle on the right side of your heart becomes thickened and enlarged.

When your heart gets larger, it’s more prone to wear out. This larger size can increase blood pressure in your heart, which increases the force placed on arteries and blood vessels throughout the rest of your body. It’s also harder for a larger heart to conduct the electrical impulses that keep it beating, leading to serious health problems.

Right ventricular hypertrophy is usually caused by a problem in your lungs. You can also have left ventricular hypertrophy, but this is usually due to increased blood pressure or a problem with the aortic valve in your heart.

What are the symptoms?

Right ventricular hypertrophy doesn’t always cause symptoms. Often, the left ventricle tries to compensate for the problems with the right ventricle. This means that some people don’t know they have right ventricular hypertrophy until it’s more advanced.

However, if you have right ventricular hypertrophy due to an underlying lung condition, such as pulmonary arterial hypertension, you might notice symptoms, including

  • chest pain/pressure
  • dizziness
  • fainting
  • shortness of breath
  • swelling in the lower extremities, such as the ankles, feet, and legs

These symptoms are similar to those of many other conditions, including congestive heart failure, so it’s best to see your doctor as soon as possible if you have any of these symptoms.

What causes it?

Right ventricular hypertrophy is usually caused by a lung-related condition or a problem with the structure or function of the heart.

Lung conditions associated with right ventricular hypertrophy generally cause pulmonary arterial hypertension, which causes the arteries carrying blood to your lungs to narrow. Conditions that can cause this include:

Problems with the structure or function of your heart that can cause right ventricular hypertrophy include:

How is it diagnosed?

Your doctor will start by asking about your medical history as well as any lifestyle factors, such as smoking, that could impact the health of your heart.

Next, they’ll likely use one of three tests to get a better idea of how your heart’s functioning:

  • Chest X-ray. This allows your doctor to see whether the right side of your heart looks larger than usual.
  • Electrocardiogram (EKG or ECG). This measures how well your heart conducts the electrical impulses that trigger heartbeats. If the right side of your heart is larger, it’ll have a harder time conducting these impulses.
  • Echocardiogram. An echocardiogram is an ultrasound of your heart’s chambers and valves. Your doctor can use it to see whether these structures are unusually large.

Your doctor might use a combination of these tests to confirm whether or not you have right ventricular hypertrophy.

How is it treated?

The treatment of right ventricular hypertrophy depends on the underlying cause. If pulmonary atrial hypertension is the cause, you may need medication to help relax your pulmonary artery, such as sildenafil (Revatio).

Other medications your doctor might prescribe to improve heart function include:

If right ventricular hypertrophy is making it hard for your heart to beat consistently, you may also need a pacemaker. This is a device that helps your heart maintain a regular rhythm.

You may also need surgery if you have a problem in the structure or valves of your heart, neither of which can be fixed with medication alone.

Are there any complications?

If left untreated, right ventricular hypertrophy can increase your risk of congestive heart failure. If you do have right ventricular hypertrophy, make sure to closely follow the treatment plan recommended by your doctor.

You can also reduce your risk of heart failure by avoiding lifestyle factors that place added stress on your heart, such as:

  • eating a lot of salty foods
  • smoking
  • being overweight
  • excessive alcohol consumption

Right ventricular hypertrophy can also cause cardiac arrest, which causes your heart to suddenly stop beating. This tends to happen in young athletes who don’t know they have an underlying heart condition. For this reason, many young athletes are required to get an EKG before joining a sports team.

Living with right ventricular hypertrophy

Right ventricular hypertrophy doesn’t always cause symptoms, which means it often isn’t discovered until its later stages. If left untreated, it can lead to some serious complications, including heart failure.

If you have any symptoms of a heart problem, including chest pain, shortness of breath, or swelling in your legs, your doctor as soon as possible.

Once diagnosed, right ventricular hypertrophy usually responds well to medication, lifestyle changes, surgery, or a combination of all three.

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