Load on the right atrium ecg causes. Right atrial hypertrophy: manifestations and diagnostic measures

Left ventricular hypertrophy, or cardiomyopathy, is a very common heart disorder in patients diagnosed with hypertension. This is a rather dangerous disease, since its final stage is often death in 4% of all cases.

1. What is it?

Hypertrophy implies thickening of the walls of the left ventricle and this does not occur due to the characteristics of the internal space. The septum between the ventricles changes, and tissue elasticity is lost.

The thickening is not necessarily uniform, but can occur only in some areas of localization.

Hypertrophy itself is not a diagnosis, but is one of the symptoms of any disease of the cardiovascular system. This is mainly hypertension. In addition, we can distinguish various types of heart defects, frequent and heavy loads on the heart muscle.

In order for the heart muscle to begin to increase in size, the following conditions are necessary:

A large load, which leads to expansion of the internal cavity of the heart. At the same time, during systole, the myocardium begins to contract more strongly.
Pressure load on the heart, which is characterized by the fact that in order to expel blood, muscle contraction must occur much more often and stronger.

Both of these provoking factors will contribute to the thickening of contractile fibers - myofibrils of cardiomyocytes. At the same time, mechanisms for increasing connective tissue are launched. The heart needs to increase its ability to expand more and more, so collagen development will occur faster.

Therefore, it turns out that hypertrophy in almost all cases leads to disruption of the structure of the myocardium. The more intense the process of hypertrophy, the faster the ratio of collagen and myocytes decreases.

The most dangerous situation is intense and sudden physical activity. This applies to people who smoke, abuse alcohol, or sedentary individuals whose physical activity increases sharply. If a modification of the left ventricle did not lead to death, this does not mean that it is safe for health. It can lead to quite serious disorders - it could be a myocardial infarction or stroke.

Left ventricular hypertrophy is a signal that indicates a worsening of the conditions in which the myocardium is located at that time. This is like a warning, indicating to a person the need to stabilize his blood pressure and correctly distribute the load.

2. Causes of hypertrophy

One of the main causes of left ventricular hypertrophy is heredity. A genetic predisposition has been observed in those people who have a history of heart disease in their family. Thickening of the walls of the left ventricle in such people is observed quite often.

The reasons also include the following:

hypertonic disease;
cardiac ischemia;
diabetes;
atrial fibrillation;
atherosclerosis;
aortic valve stenosis;
heavy weight;
diseases of the peripheral system;
great physical activity;
emotional instability;
anxiety, excitement, stress;
muscular dystrophy;
insufficient sleep and rest;
inactivity;
smoking;
alcoholism;
Farby's disease.

Long and intense sports and frequent training can also cause left ventricular hypertrophy. All of the above factors contribute to an increase in blood pulsation, as a result of which the heart muscle thickens. And this leads to thickening of the walls of the left ventricle.

3. Symptom

Hypertrophy provokes changes not only in the area of the walls of the left ventricle. This expansion also extends outward. Very often, along with thickening of the inner wall, the septum between the ventricles becomes thicker.

The symptoms of the disease are heterogeneous. In some cases, patients do not even know for several years that they have left ventricular hypertrophy. It is also possible that at the very beginning of the disease the state of health becomes simply unbearable.

Angina is the most common symptom indicating ventricular hypertrophy. Its development occurs due to compression of the blood vessels that provide nutrition to the heart muscle. Atrial fibrillation also occurs, atrial fibrillation and myocardial starvation are observed.

Very often a person has a condition in which the heart seems to freeze for a moment and does not beat at all. This leads to loss of consciousness. Sometimes the appearance of shortness of breath may indicate hypertrophy.

There are a number of additional symptoms of left ventricular hypertrophy:

high blood pressure;
pressure changes;
headache;
arrhythmia;
poor sleep;
general weakness and poor health;
heartache;
chest pain.

The list of diseases in which hypertrophy is one of the symptoms is as follows:

congenital heart defect;
swelling in the lungs;
glomerulonephritis in the acute stage;
myocardial infarction;
atherosclerosis;
heart failure.

4. Treatment

In order to carry out qualified treatment, it is necessary not only to diagnose the disease, but also to determine its nature of occurrence and the characteristics of its course. Based on the examination data obtained, the most optimal method of treating hypertrophy is selected, the purpose of which is to normalize myocardial function and provide adequate medical or surgical treatment.

Treatment of hypertrophy involves the use of the drug verampil along with beta blockers. Their combined use reduces the symptoms of the disease and improves the general condition of the patient. As additional therapy, it is recommended to follow a certain diet and give up unhealthy habits. Physical activity should be moderate.

The possibility of surgical intervention should not be ruled out. Its essence is to eliminate a section of the heart muscle that has been hypertrophied.

If symptoms relevant to this disease appear, you should consult a cardiologist. Do not delay treatment, as the disease can cause serious complications and death.

Drugs

Correctly prescribed therapy includes drugs that normalize blood pressure and reduce heart rate. ACE inhibitors are also used to prevent the progression of hypertrophy. Thanks to them, the symptoms of the disease gradually decrease.

All medications are primarily aimed at improving myocardial nutrition and restoring normal heart rhythm. These include: Verapamil, beta blockers and antihypertensive drugs (Ramipril, Enalaprim and others).

Treatment with folk remedies

Traditional methods of treating traditional medicine in the treatment of hypertrophy are used, but not often. The exception is those substances that have antioxidant properties, as well as some plants that have a calming effect.

Plants that can strengthen the walls of blood vessels and cleanse the blood of atherosclerotic plaques are also used. Taking vitamins and dietary supplements containing potassium, omega, calcium, magnesium and selenium is useful.

As additional remedies for hypertrophy, decoctions and infusions of the following medicinal herbs are used:

Mix 3 tablespoons of motherwort herb, 2 tablespoons of dried rosemary and wild rosemary, 1 spoon of kidney tea. Pour a large spoonful of this mixture into one and a half glasses of cold water and boil for 5 minutes. Wrap the broth in a warm cloth and leave for 4 hours. After straining, take half a glass warm three times a day before meals. The interval between taking the decoction and eating should be a quarter of an hour.
Pounded cranberries with sugar, a small spoonful three times a day after meals, is considered very healthy.

Diet

A therapeutic diet is an integral part of the treatment of hypertrophy. You should eat up to 6 times a day in small portions.

You should avoid salt, fried, fatty and smoked foods. The diet should always include dairy and fermented milk products, fresh fruits and vegetables, seafood, and lean meats. Flour products should be limited, as well as reduce the consumption of sweet foods to a minimum, and limit animal fats.

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Symptoms

LVH usually develops gradually. A patient in the early stages may not experience any symptoms. As LVH progresses, you may experience:

dyspnea;
fatigue;
chest pain, often after exercise;
a feeling of rapid or fluttering heartbeat;
dizziness or fainting.

You should seek immediate medical attention in the following cases:

chest pain lasts more than a few minutes;
severe shortness of breath;
severe, recurring dizziness or loss of consciousness.

If a person has mild shortness of breath or other symptoms (such as palpitations), they should visit their doctor.

Causes

Myocardial hypertrophy can occur when certain factors make the heart work harder. These include:

High blood pressure (arterial hypertension). This is the most common cause of myocardial hypertrophy. More than a third of people with LVH are diagnosed with hypertension.
Aortic valve stenosis. This is a narrowing of the opening of the valve that separates the aorta from the left ventricle. To pump blood through this narrowed opening, the left ventricle needs to contract harder.
Hypertrophic cardiomyopathy. This genetic disease develops when the heart muscle becomes abnormally thick. Sometimes this pathology occurs in children.
Sports training. Intense and long-term strength training can lead to the development of adaptation of the heart to increased stress. It is not yet clear whether such myocardial hypertrophy can lead to impaired elasticity of the heart muscle and the development of the disease.

In addition, there are the following risk factors for the development of LVH:

elderly age;
overweight;
family history;
diabetes;
Gender – Women with hypertension have a higher risk of developing LVH than men with the same blood pressure.

Why is LVH dangerous?

With left ventricular hypertrophy, the structure and function of the heart changes. An enlarged left ventricle may:

weaken the force of your contractions;
lose elasticity, which interferes with the proper filling of the ventricle with blood and increases pressure in the heart;
compress the coronary arteries that supply blood to the heart itself.

How is LVH diagnosed?

Upon examination, the doctor may detect increased blood pressure, the borders of the heart shifted to the left and the apex beat, and the presence of murmurs above the heart. You can clarify the diagnosis using the following methods:

Electrocardiogram (ECG) - with its help, a cardiologist can detect voltage signs, which are manifested by an increase in the amplitude of the waves. LVH is often associated with impaired myocardial repolarization processes, which can also be detected on the ECG.
Echocardiography (ultrasound of the heart) - can show thickened walls of the left ventricle and help detect cardiac pathology leading to LVH (for example, aortic valve stenosis).
Magnetic resonance imaging.

How to treat LVH?

Treatment for LVH depends on its cause and involves medication or surgery.

LVH associated with hypertension is treated with blood pressure control measures. These include lifestyle changes (weight loss, regular exercise, diet, smoking cessation) and medications (angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers and diuretics).
Sports-related LVH usually does not require treatment. A person with this problem needs to stop exercising for 3 to 6 months. After this time, a repeat echocardiogram should be performed to determine the thickness of the heart muscle and see if it has decreased.
Hypertrophic cardiomyopathy is a rare disease that must be treated under the close supervision of an experienced cardiologist. Therapy can be conservative or surgical.
LVH caused by aortic stenosis may require surgical treatment (valve repair or valve replacement).

If you have LVH, it is very important to carry out the correct treatment and follow the doctor’s recommendations. Although this condition can be successfully controlled, there is a risk of developing heart failure.

Prevention

The best way to prevent the development of myocardial hypertrophy is to maintain normal blood pressure. To do this you need:

Measure your blood pressure regularly and frequently.
Make time for physical exercise.
Follow a diet - avoid salty and fatty foods, eat more fruits and vegetables, do not drink alcoholic beverages (or drink them in moderation).
Quit smoking.

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Causes of left ventricular hypertrophy

Myocardial thickening in the left ventricular area is not a separate disease, but rather a consequence of serious cardiovascular pathologies:

Hypertension and symptomatic hypertension. In these conditions, the left ventricle constantly works with maximum force, so the myocardial muscle fibers in this part of the heart grow and increase in volume.
Heart defects, especially aortic valve stenosis. It becomes an obstacle to the normal flow of blood from the left ventricle and causes the muscles of the latter to contract more intensely.
Atherosclerosis of the aorta, in which the left ventricle is also under constant increased tension.

In addition, the left ventricle quite often hypertrophies in young people involved in sports, as well as loaders. In these categories of patients, the main cause of changes in the myocardium is systematic severe physical activity, during which the heart works to wear out.

Obese people also suffer from hypertrophic changes in the left ventricle; their hearts have to pump blood in large volumes and for a long duration of the vascular bed. It is also worth highlighting the possibility of a hereditary predisposition to thickening of the walls of the heart.

What is the danger of left ventricular hypertrophy?

The problem with this pathology is that with it, only the myocardium grows in the heart wall, other important structures (vessels, elements of the conduction system) remain in place, and the wall itself loses its elasticity. This leads to ischemia of muscle cells (they all simply do not have enough oxygen), disruption of rhythm, contractility and blood filling of the left ventricle. Therefore, patients have an increased risk of developing a heart attack, heart failure, ventricular arrhythmias, and blockades. Well, the most dangerous complication is sudden death.

Signs of left ventricular hypertrophy

You can suspect the presence of left ventricular hypertrophy based on the following signs:

pain in the heart, it can have a different nature and duration;
dizziness and weakness;
shortness of breath;
a feeling of sudden sinking of the heart, followed by a strong palpitation;
repeated fainting;
swelling of the limbs;
sleep disturbance;
physical inability to do heavy work.

It is worth noting that in half of patients, hypertrophy can occur unnoticed at first, this is especially true for athletes.

Basic principles of treatment

Cardiologists recommend that all patients with myocardial hypertrophy, first of all, give up smoking and alcohol and try to normalize weight. In addition, switch to a diet that is beneficial for the myocardium and helps normalize blood pressure. In the diet it is necessary to limit salt (it is better not to add enough salt to dishes at all), animal fats from meat and dairy products, easily digestible carbohydrates, all offal, smoked and preserved foods, as well as caffeinated drinks. Instead, you should diversify your diet with healthy vegetable oils, fresh vegetables, fruits, seafood, low-fat cottage cheese and kefir, and cereals.

After consultation with a cardiologist, it is recommended to expand your physical activity with walks and jogging in the park, swimming, and physical therapy. In this case, all loads should be moderate. Also, for myocardial hypertrophy, drug therapy is used aimed at normalizing blood pressure, restoring rhythm and improving myocardial function. For this purpose, drugs of the following groups are used: ACE inhibitors, calcium antagonists, sartans and other drugs.

If drug therapy does not help, the pathology progresses, the normal functioning of the heart septa and valves is disrupted, and various types of surgical operations are performed.

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Causes of left ventricular hypertrophy

The main pathogenetic mechanism in the development of myocardial hypertrophy is a long-term disruption of the ejection of blood from the ventricular cavity into the aorta.

An obstacle to normal release may be:

narrowing of the aortic opening (part of the blood remains in the LV cavity due to stenosis of the aortic valve);
insufficiency of the aortic valves (due to incomplete closure of the semilunar valves, after completion of contraction of the LV myocardium, part of the blood returns to its cavity).

Stenosis can be congenital or acquired. In the latter case, its formation is caused by infective endocarditis (as a result of calcification of the leaflets), rheumatism, senile vascular calcification (usually after 65 years), systemic lupus erythematosus, etc.

The causes of aortic valve insufficiency can also be congenital pathologies and hereditary pathologies of connective tissue, infectious diseases, syphilis, SLE, etc.

In this case, the ability of the arteries to stretch under the pressure of the blood flow is impaired. An increase in arterial stiffness leads to an increase in the pressure gradient, an increase in the load on the heart muscle and contributes to an increase in the number and mass of cardiomyocytes in response to overload.

Other common causes of left ventricular hypertrophy are:

increased physical activity, especially in combination with a low-calorie diet;
atherosclerosis;
arterial hypertension;
obesity;
endocrinopathies.

In the first case, the so-called “athletic heart” is formed - this is a complex of adaptive mechanisms leading to left ventricular hypertrophy in response to volume overload. That is, due to increased physical activity, the heart is forced to pump large volumes of blood, which leads to an increase in the number of muscle fibers.

As a result, the “performance” of the heart increases and adaptation to intense training occurs. However, long-term overload, especially in combination with fashionable low-calorie diets, contributes to the rapid depletion of compensatory mechanisms and the appearance of symptoms of heart failure (HF).

Endocrine disorders, obesity, atherosclerosis and arterial hypertension (hereinafter referred to as hypertension) can be either interconnected links in one chain or individual risk factors. Excess body weight leads to the formation of resistance (addiction) to insulin in peripheral tissues and the development of type 2 diabetes, metabolic disorders, hyperlipidemia, atherosclerosis and increased blood pressure.

As a consequence of hypertension, an overload of blood volume is created, and atherosclerotic plaques create obstacles in the path of the blood wave, disrupting its hemodynamic properties, and contribute to increased rigidity of the vascular wall. Left ventricular hypertrophy develops in response to increased workload on the heart.

Among the endocrinological causes of LVH, the “thyrotoxic heart” should also be distinguished. This refers to left ventricular hyperfunction as a result of increased contractility of the heart muscle due to increased influence of the sympathetic nervous system and high output syndrome.

This leads to a sequential chain of pathogenetic mechanisms:

hyperfunction,
depletion of compensatory mechanisms and dystrophy,
cardiosclerosis,
outcome in heart failure.

Also, diseases of the kidneys and adrenal glands, leading to arterial hypertension, can lead to the formation of LVH.

Hereditary risk factors for the development of left ventricular hypertrophy also include syncope, severe arrhythmias, and sudden death syndrome in relatives of the patient. These data are important for excluding the familial form of hypertrophic cardiomyopathy.

Types of LVH

Left ventricular hypertrophy can be asymmetrical or symmetrical (concentric).

With asymmetric, pathological changes are observed in individual segments or walls of the LV.

According to the localization of the pathological process, the following are distinguished:

LVH with involvement of the interventricular septum (about 90 percent of cases);
midventricular;
apical;
combined lesion of the free wall and septum.

Symmetric hypertrophy of the left ventricle is characterized by the spread of the pathological process to all walls.

Based on the presence of outflow tract obstruction, it is classified:

obstructive cardiomyopathy, also called idiopathic hypertrophic subaortic stenosis (occurs in 25 percent of cases);
non-obstructive cardiomyopathy (diagnosed in 75% of cases)

According to the course and outcome, LVH is distinguished with:

stable, benign course;
sudden death;
progressive course;
development of atrial fibrillation and complications;
progressive heart failure (end stage).

Symptoms of the disease

The insidiousness of the disease lies in its gradual development and slow appearance of clinical symptoms. The initial stages of myocardial hypertrophy may be asymptomatic or accompanied by vague, nonspecific complaints.

Patients suffer from headaches, dizziness, weakness, insomnia, increased fatigue and decreased overall performance. Subsequently, chest pain and shortness of breath develop, increasing with physical activity.

Arterial hypertension is both one of the provoking factors in the development of LVH and one of the important symptoms of this disease. When the body's compensatory capabilities are depleted, complaints of unstable blood pressure arise, ranging from elevated numbers to a sharp drop, even to severe hypotension.

The severity of complaints depends on the form and stage, the presence of obstruction, heart failure and myocardial ischemia. Symptoms also depend on the underlying disease.

With aortic valve stenosis, the classic picture of the disease is manifested by a triad of symptoms: chronic heart failure, exertional angina and syncope (sudden fainting).

Syncope is associated with a decrease in cerebral blood flow as a result of a decrease in blood pressure, due to insufficient cardiac output during decompensation of the disease. The second cause of syncope is baroreceptor dysfunction and the vasodepressor response to a marked increase in left ventricular systolic pressure.

In young people and children, LVH can be detected completely accidentally during an examination.

What is the danger of hypertrophy?

Decompensation of the pathological process leads to:

obstruction of the excretory compartment;
progressive heart failure (HF);
severe rhythm disturbances, up to ventricular fibrillation (VF);
coronary heart disease;
cerebrovascular accident;
myocardial infarction;
sudden death syndrome.

Sometimes left ventricular myocardial hypertrophy can be asymptomatic and lead to premature death. This course is typical for hereditary forms of cardiomyopathies.

Stages of hypertrophy and energy processes

There are three stages during the course of the disease:

The stage of initial changes and adaptation (provoking factors lead to an increase in the number and mass of cardiomyocytes and increased consumption of energy reserves in cells). May be asymptomatic or with minimal, nonspecific complaints;
Stage of compensated course (characterized by the appearance and progression of clinical symptoms due to the gradual depletion of energy reserves in cells, oxygen deficiency, and ineffective heart function).
Hypertrophy of the left ventricular myocardium with decompensated course and severe heart failure.

The last stage is characterized by:

dystrophic changes in the myocardium,
ischemia,
dilatation of the LV cavity,
cardiosclerosis,
interstitial fibrosis,
extremely poor prognosis for survival.

Diagnostics

Genetic testing is performed to exclude hereditary forms of HCM.

To clarify the stage of the disease, markers of chronic heart failure are examined.

Of the instrumental studies, the following are mandatory:

LVH on ECG,
daily ECG monitoring,
transthoracic resting cardiography (ECHO-CG) and stress ECHO-CG,
tissue Doppler study.

Echo-KG allows you to evaluate:

location of the site of myocardial hypertrophy,
wall thickness,
LV ejection fraction,
dynamic obstruction,
condition of the valve apparatus,
volume of the ventricles and atria,
systolic pressure in the LA,
diastolic dysfunction,
mitral regurgitation, etc.

Chest x-ray allows you to assess the degree of left ventricular enlargement.

If necessary, MRI and CT of the heart are performed.

To identify atherosclerotic changes in the coronary vessels, coronary angiography is performed.

Treatment of LVH

Treatment tactics depend on the severity and stage of the disease, the degree of heart failure and the LV ejection fraction.

The basis of therapy is the elimination of the provoking factor and treatment of concomitant diseases.

Patients with systolic dysfunction and ejection fraction less than 50% are treated according to the chronic HF treatment protocol.

The main drugs used for treatment are:

beta blockers,
ACE inhibitors,
calcium channel blockers,
angiotensin receptor blockers,
antiarrhythmic drugs,
diuretics.

Surgical treatment is indicated for patients with an obstructive form.

Forecast

The prognosis of the disease depends on the cause of LVH, the type of course of the disease (stable or progressive), the functional class of heart failure, the stage of the disease, the presence of obstruction and aggravating conditions (arterial hypertension, endocrine disorders).

Syncope attacks also indicate a decompensated course and a poor prognosis for survival.

However, in patients with an uncomplicated family history and a stable course of the disease, with complex timely treatment, six-year survival rates are about 95%.

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What to do if you have heart failure

Modern medicine has learned to correct many diseases that were previously considered fatal. In particular, this applies to various heart defects. But besides them, there are many more dangerous manifestations in the work of the heart that can lead to a sad outcome.

As we know from school biology lessons, the heart consists of four parts: two ventricles (they push blood into the bloodstream) and two atria (they receive blood from the circulation). Therefore, the diagnosis of “cardiac hypertrophy” most often affects only one part of the muscle and they arise for various reasons.

The load on the right atrium occurs for various reasons. This diagnosis only conceals that the atria are not working evenly. The right atrium is responsible for pumping blood to the lungs. This is where blood comes with oxygen, which is absorbed by all tissues. That is why, if an increased load on the right atrium is detected, the lungs must be checked. The work of the atria is directly related to the work of the lungs. And many pathologies give symptoms in both the heart and lungs.

Another cause of strain on the right atrium may be congenital heart disease. A defect such as atrial septal defect puts an improper load on the work of the heart muscle.

So, what exactly can lead to strain on the right atrium? This is high blood pressure. This is especially dangerous in the pulmonary artery. This happens with obstructive pulmonary disease or bronchitis.

Strain on the right atrium also occurs with pulmonary embolism. This occurs due to disruption of blood flow between the heart and lungs. To compensate for the lack of oxygen, the atrium has to work harder. A blood clot also forms and this already threatens other troubles.

Congenital heart defects include those defects that were acquired during fetal development. The reasons may also be different. Most often these defects relate to the pulmonary valve, mitral valve and tricuspid valve.

Ventricular hypertrophy occurs frequently and leads to right atrial hypertrophy. It is usually caused by diseases such as pulmonary hypertension, ventricular septal defect, and tetralogy of Fallot (a heart defect that occurs in newborn infants).

As with most diseases, right atrial hypertrophy is asymptomatic. And, as a rule, when symptoms appear, the disease is already significantly advanced. Therefore, if you experience dizziness, loss of consciousness, swelling of the lower extremities, or rapid heartbeat, you should immediately consult a doctor.

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Right atrial hypertrophy during pregnancy

Quite complex extragenital diseases during pregnancy include cardiovascular pathologies. Any pregnancy is characterized by gradual, constant, sometimes sudden dynamics with obvious physiological and hormonal changes. The cardiovascular system undergoes enormous stress during pregnancy, for this reason it is important to promptly establish the correct diagnosis, as well as assess a woman’s ability to bear and give birth. The ideal option would be to resolve the issue of permissibility of pregnancy before conception in order to prevent health risks and threats to the lives of mother and baby.

It is known that hypertrophy of the right atrium during pregnancy is not an independent disorder. The disease can be caused by both congenital and acquired pathologies, including during pregnancy.

In order to control the condition, pregnant women with heart problems are recommended to be hospitalized three times during the entire period. The first placement in a hospital is necessary for a thorough examination of the defect, determining the activity of the pathological process and the functioning of the circulatory system, with consideration of the issue of possible termination of pregnancy. Readmission to the hospital is required due to peak physiological stress to maintain cardiac function. Staying in the hospital for the third time helps specialists determine the method of delivery.

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Causes

In medical practice, hypertrophy of the right atrium, compared to the left, is quite rare. This is due to the fact that the left ventricle is responsible for hemodynamics (blood movement through the vessels) in the systemic circulation and is subject to considerable stress when the right ventricle directs blood to the pulmonary circulation. And excessive load on the ventricle, as a rule, becomes the cause of functional changes in the accompanying atrium. The right atrium experiences overload as pressure in the pulmonary artery increases. This moment is influenced by various circumstances:

pulmonary diseases: bronchitis, bronchial asthma, pulmonary embolism (blockage of the arterial bed of a paired organ with a blood clot), emphysema (excessive accumulation of air in the organs), pneumonia or pneumonia;
narrowing of the tricuspid valve, which separates the right atrium and ventricle. The valve opening decreases, and with it the amount of flowing blood;
congenital changes in heart structures (defects);
myocardial infarction;
regular physical activity.

Symptoms

Overload of the right atrium develops quite quickly. This picture is clearly visible on the electrocardiogram (ECG). But when the patient recovers, right atrial hypertrophy and its signs gradually disappear. Typically, thickening of the walls of the right atrium does not manifest itself at first, that is, it occurs without symptoms. However, in an advanced form, the following signs of right atrium hypertrophy occur:

pain in the chest area;
cough, respiratory system dysfunction;
pale skin, cyanosis, in which the skin of the face, extremities and mucous membranes turns blue;
minor discomfort in the heart area;
noticeable enlargement of the abdomen and protrusion of veins;
swelling of the legs.

Diagnostic tests

Signs of load on the right atrium are very noticeable after an exacerbation of various diseases: pneumonia, bronchitis, emphysema, pulmonary embolism and others. They are clearly visible in the graphical picture of the ECG. A cardiogram helps determine when the atrium is heavily overloaded and shows various pathological changes in the heart. Therefore, experts strongly recommend periodically performing an ECG analysis in order to diagnose hypertrophy in the early stages.

When a cardiologist deciphers an electrographic pattern, he first looks at the shape and height of the P wave (showing contraction of the atria). Excitation of the right atrium is reflected by the first part of the P wave. After a detailed study of the test results, based on the patient’s complaints, the doctor draws conclusions and makes a diagnosis. ECG is the main and effective method for studying various cardiac pathologies. If the ECG reveals signs of hypertrophy, the doctor recommends that the patient undergo a computed tomography (CT) scan of the chest or x-ray to make an accurate diagnosis.

Treatment

GLP is a secondary problem. Therefore, it is necessary to treat the root cause. Depending on the type of disease that provoked the enlargement of the atrium walls, the cardiologist prescribes a specific drug treatment. Medicines, in combination with a healthy lifestyle and proper nutrition, can restore the functioning of the heart chamber and prevent the likelihood of relapse. In case of congenital changes in the structures of the heart, surgical treatment is performed.

Prevention

Experts are unanimous in their opinion: in order to avoid problems with the functioning of the parts of the heart, it is necessary to maintain an excellent mood and treat physical activity without fanaticism. To stay toned and in great physical shape, you can go swimming, ride a bike, or take walks in a park or forest. It is also necessary to monitor your psycho-emotional state: worry and be nervous less, rejoice and enjoy life more.

Complications

The prognosis of atrial hypertrophy is determined by the severity of the disease. Acquired defects are easier to cure when the disease first appears. Therefore, hypertrophy is not a reason for panic and concern. If you diagnose the disease early, select competent and effective therapy, and follow all the doctor’s recommendations, then the likelihood of recovery will be high.

Listen to your own body, its signals and alerts. Begin treatment immediately after diagnosing hypertrophy to prevent complications in the circulatory system.

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Causes

Congenital malformations such as tetralogy of Fallot can lead to right atrial hypertrophy.

Right atrium pressure overload is characteristic of tricuspid valve stenosis. This is an acquired heart defect, in which the area of the opening between the atrium and the ventricle decreases. Tricuspid valve stenosis may be due to endocarditis.

With another acquired heart defect, tricuspid valve insufficiency, the right atrium experiences volume overload. In this condition, blood from the right ventricle, when it contracts, flows not only into the pulmonary artery, but also back into the right atrium, causing it to work under overload.

The right atrium is enlarged in some congenital heart defects. For example, with a significant atrial septal defect, blood from the left atrium enters not only the left ventricle, but also through the defect into the right atrium, causing its overload. Congenital heart defects accompanied by the development of HPP in children - Ebstein's anomaly, tetralogy of Fallot, transposition of the great vessels and others.
Right atrium overload can occur quickly and manifest primarily on the electrocardiogram. This condition can occur during an attack of bronchial asthma, pneumonia, myocardial infarction, or pulmonary embolism. Subsequently, with recovery, the signs of HPP gradually disappear.

Sometimes electrocardiographic signs of HPP appear when the heart rate increases, for example, against the background of hyperthyroidism. In thin people, electrocardiographic signs of HPP may be normal.

Symptoms and complications

GPP itself does not cause any symptoms. The patient is only concerned about signs associated with the underlying disease. When chronic pulmonary heart disease develops, this may include shortness of breath with light exertion and at rest, especially when lying down, coughing at night, and hemoptysis.

If the right atrium ceases to cope with the increased load, signs of circulatory failure in a large circle appear, associated with stagnation of venous blood in the body. These are symptoms such as heaviness in the right hypochondrium, an increase in the size of the abdomen, swelling of the legs and anterior abdominal wall, the appearance of dilated veins in the abdomen and others.

Diagnostics

The main methods for diagnosing HPP are electrocardiography and ultrasound examination of the heart. On the electrocardiogram, special changes in the P wave appear, which are called “P-pulmonale,” which emphasizes the connection of GPP primarily with lung diseases.

Additionally, an x-ray or computed tomography of the chest organs may be performed. To clarify the cause of HPP, additional research methods are prescribed.

Treatment

GPP is a symptom of the disease and has no independent treatment. Treatment of the underlying disease is carried out. In cases of heart defects, surgical correction is performed.

Blood enters the left atrium through the vena cava, passing through the large vein. Next, the blood moves to the right heart chambers. But in some cases, dysfunction of certain departments can be observed. Most often this is an overload of the left atrium, which is extremely dangerous to human health.

The consequence of atrial overload is hypertrophy of the left atrium. With this pathology, there is a thickening of the walls of the left ventricle, due to which the tissues lose their elasticity. It is worth noting that if the walls increase in places, then this situation can bring additional disastrous results in the form of dysfunction of the heart valves.

In medicine, it is generally accepted that if the increase in the size of the walls is more than 15 mm, then this is already a pathology. In addition, it is the most common cause of death in young athletes. This situation can arise both among people of retirement age and among young people. The main danger of the disease is that it increases many times, stroke and death.

It is worth knowing that hypertrophy can progress and aggravate the situation, however, all unpleasant consequences can be avoided if you seek medical help in a timely manner.

Reasons for overload

Pathologies of the left side of the heart occur much more often than the right. The thickening of the walls itself is not an independent disease, but only indicates the presence of cardiac pathologies. The most common reasons why this situation may arise are:

It is worth noting that if the pathology appears due to the patient’s excess weight, then treatment in this case is useless until the person loses weight. To do this, you need to try to eat right. If you cannot solve this problem on your own, you should contact a nutritionist for help.

For avid athletes who have this anomaly, it is necessary to reduce physical activity and be constantly monitored by a cardiologist.

To summarize, I would like to note that before being treated with medications, it is necessary to identify the cause of the overload of the left side, and only then begin drastic measures.

Apr 8, 2018 Violetta Doctor

Hypertrophy, enlargement, of any organ often occurs in the body to compensate for some deficiency or insufficiency. The heart consists of four sections, and each of them can be enlarged. Everyone has their own reasons and consequences for this. Hypertrophy of the heart is not an independent disease, but a syndrome of manifestations of those disorders that can cause hypertrophy.

Let's take a closer look at atrial hypertrophy

Genetic disorders can cause many diseases, including left atrium disorders. Other reasons may be:

Obesity.
Mitral valve stenosis and insufficiency. Either the blood backflows and the left atrium overflows, or it needs to work harder to pump blood through the narrowed opening between the atrium and the ventricle. This causes dilatation of the left atrium.
Hypertrophic cardiomyopathy.
Stress.
High blood pressure.

An increase in pressure in the vessels leads to an increase in the load on the heart chambers, and they respond by increasing their size. The danger is that hypertrophy leads to disruption of the elasticity of the walls of the heart and an increasing deterioration in its functioning.

Symptoms of left atrial hypertrophy depend on the degree of impairment. With slight hypertrophy they may not exist. If the left atrium is sufficiently enlarged, then symptoms characteristic of heart failure appear: increased fatigue, shortness of breath, pain in the heart area, rapid heartbeat.

Right atrium hypertrophy occurs due to pathology in the pulmonary circulation, which may be associated with diseases of the lungs and blood vessels, tricuspid valve insufficiency, as well as congenital heart defects. As a result of these diseases, the pressure in the pulmonary artery increases. The heart works with great stress, because it needs to overcome the increase in pressure in the artery, the load on the right atrium increases. This causes an enlargement of the right atrium, and subsequently its insufficiency.

So, right atrial hypertrophy. Her reasons:

Lung diseases and bronchitis cause high blood pressure.
Stenosis of the tricuspid valve, which is located between the right atrium and the right ventricle. It ensures normal passage of blood from the right atrium to the right ventricle. The narrowing of the opening between these parts of the heart leads to a decrease in the volume of blood passing from the atrium to the ventricle. To restore normal blood flow, the atrium squeezes blood into the ventricle with greater force. There is an increased load on the right atrium.

Insufficiency of the tricuspid valve, as a result, blood can flow from the ventricle into the atrium.
A pulmonary embolism prevents blood from flowing freely between the heart and lungs. The heart is forced to work hard, with the main load falling on the right atrium and ventricle.
Congenital heart defects.
Right ventricular hypertrophy often leads to right atrial hypertrophy.

Symptoms of right atrium enlargement

Breathing problems.
Fatigue.
Chest pain.

Signs of strain on the right atrium appear after an acute situation, for example, pneumonia, an attack of bronchial asthma, or pulmonary embolism. After normalization of the condition, they may gradually disappear. These signs are detected on the electrocardiogram. The electrocardiogram also shows that the load on the left atrium is increased. When decoding the cardiogram, the cardiologist pays attention to the height and location of the teeth and draws conclusions based on the detected deviations. Right atrial hypertrophy is much less common than left atrial hypertrophy, since the functioning of the left atrium is influenced by many more factors.

Diagnostics

Various examinations of the patient are needed. What does the doctor pay attention to? Listening with a stethoscope may reveal a heart murmur. Echocardiography will tell you the size and thickness of the walls of the heart chambers. An electrocardiogram reveals disturbances in heart contractions, which also occurs with hypertrophy of various chambers of the heart.

Treatment of right atrial hypertrophy

The goal of treatment is to improve the patient's general condition by reducing the size of the atrium to normal. This significantly improves heart function and oxygen supply to the body. Of course, an integrated approach and treatment of the underlying disease is necessary. Drug therapy will help, but no heart disease can be cured without lifestyle changes. No one doubts the need to give up bad habits; you also need to limit salt and foods that contribute to the accumulation of cholesterol. If we are talking about heart valve defects, then surgery may be required.

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Causes

The reasons for the development of HPP, enlargement of the left ventricle, and other parts of the heart still differ from each other, although there are some identical factors. Right atrium pressure overload occurs when pressure in the pulmonary artery system increases. Because of this, pressure increases in the right ventricle, then in the right atrium. This situation is observed during the formation of the pulmonary heart, and the prerequisites for this are:

lung diseases, for example, emphysema, chronic obstructive pulmonary disease;
chest deformities;
pulmonary vascular diseases, for example, thromboembolism of small branches.

Normal tricuspid valve and stenosis

It is important to consider some other factors:

The right atrium is overloaded with tricuspid valve stenosis. This heart defect is acquired under the influence of various factors. If it is, then the area of the opening between the ventricle and the atrium becomes smaller. This defect is sometimes a consequence of endocarditis.
The right atrium is overloaded with volume due to tricuspid valve insufficiency, which is also an acquired heart defect. In this case, blood from the right ventricle, during its contraction, penetrates not only into the pulmonary artery, but even back, that is, into the right atrium. For this reason, it operates with overload.

Some heart defects with which children are already born are also important. For example, if there is a defect in the septum located between the atria, then blood from the left atrium enters both the left ventricle and the right atrium, causing it to become overloaded. Congenital heart defects that cause the development of hypertrophy in children include tetralogy of Fallot, Ebstein's anomaly and some others.

Overload of the right atrium can develop quite quickly. This is clearly visible on the ECG.

Sometimes signs of hypertrophy on the ECG are observed with an increase in heart rate, and hyperthyroidism may serve as a background for this. If the patient has a thin body build, signs of hypertrophy on the ECG may be considered normal.

The listed reasons due to which hypertrophy of the right atrium develops differ from hypertrophy of other parts of the heart, for example, the left ventricle. In this case, the causes are constant high blood pressure, too much physical activity, hypertrophic cardiomyopathy, and so on.

Left atrial hypertrophy can develop due to general obesity. This condition is very dangerous if it occurs in children and young adults. Of course, some reasons may be similar, but there is still a difference.

Symptoms

GPP itself does not cause any symptoms. It all depends on the symptoms that are associated with the main disease. For example, when chronic cor pulmonale forms, the signs may be as follows:

shortness of breath at rest and with little exertion;
night cough;
spitting up blood.

When the right atrium is no longer able to cope with the heavy load, signs of insufficient blood circulation in the main circle begin to appear, which are associated with stagnation of venous blood. Clinical signs:

heaviness in the hypochondrium on the right;
increase in the size of the abdomen;
the appearance of enlarged veins in the abdomen;
swelling of the lower extremities and some other symptoms.

Diagnostics

Signs of stress on the right atrium appear after an acute situation, this can be pneumonia, bronchial asthma and others. The main method by which they can be detected is an ECG. This type of study helps to understand when the left atrium is overloaded and to identify other heart problems, so it is recommended to undergo an ECG regularly.

When a cardiologist deciphers a cardiogram, he pays attention to the location of the teeth and their height. After carefully studying the information, a conclusion is drawn and a diagnosis is made. ECG is the main research method. But in addition, the doctor may prescribe a computed tomography scan of organs located in the chest, as well as radiography. To clarify the causes of hypertrophy, additional diagnostic measures are prescribed.

Treatment

Since right atrial hypertrophy is a secondary problem, there is one treatment feature. Returning the size to normal and improving the oxygen supply to the body through good cardiac functioning can only be done by treating the root cause.

Doctors carry out medication correction of the patient’s condition. But the patient himself must also make some changes. He needs to adjust his lifestyle. The efforts of specialists may be useless if you treat your body incorrectly.

Thanks to such measures, the recovery process will be quick and effective, and the risk of relapse will also be reduced.

If cor pulmonale is detected, which is the result of problems with the lungs, doctors’ actions are aimed at compensating the functions of the lungs. Measures are taken to prevent inflammation, bronchodilators and other medications are prescribed

Cardiac glycosides are prescribed to eliminate symptoms of heart muscle diseases

If valve defects are detected, surgical intervention is performed. To eliminate the symptoms of heart muscle diseases, antiarrhythmic therapy is prescribed, which includes cardiac glycosides. Drugs that stimulate the metabolism of muscle structures also play an important role.

It is modern hypertrophy detected using ECG that allows timely treatment to be prescribed, which increases the possibility of a full recovery and a long, fulfilling life. Under no circumstances should you prescribe treatment yourself; you can cause serious damage to your health.

Preventive measures for hypertrophy are aimed at implementing a healthy lifestyle, balanced nutrition, and proper regimen. There is no need to exhaust yourself with physical exercise, but it certainly should be present in a person’s life. In addition, it is important to carry out timely treatment of diseases and those associated with the heart, blood vessels and other body systems.

cardio-life.ru

Situations leading to overload

Right atrium overload can occur in the following situations:

More blood enters the atrium than it should normally, or as a result of problems with the valve, not all the blood is pushed out during contraction; some of the blood remains in the atrium cavity.
As a result of various diseases, the load on the right side of the heart muscle increases, mainly chronic lung diseases.

In other words, strain on the heart muscle may be caused by increased blood volume or increased blood pressure.

In order to pay attention to such situations in time, we will analyze them in more detail.

Cause: Excess blood

This condition most often occurs with defects, namely stenosis or insufficiency of the tricuspid valve (tricuspid). This valve separates the ventricle from the atrium on the right.

The causes of damage to this valve are most often rheumatism, it is also possible as a result of bacterial endocarditis, relative insufficiency of the tricuspid valve may occur with enlargement and stretching of the left parts of the heart muscle.

Congenital defects of the pulmonary artery lead to the appearance of an increased volume of blood first in the ventricle, followed by overload of the atrium.

High blood pressure

Increased pressure load occurs with lung diseases such as chronic obstructive bronchitis, bronchial asthma, and emphysema.

First of all, during these diseases, the load on the ventricle increases, which becomes difficult to push blood into the pulmonary vessels.

Following the overload of the ventricle, its enlargement and expansion occurs, then the same changes occur in the atrium.

Diagnostics

There are no specific and specific clinical signs by which right ventricular overload can be determined. The presence of such a problem can be suspected if you have chronic lung diseases, as well as problems with the valves.

These abnormalities are usually detected during electrocardiography. Signs of this disorder are specific changes in the “P” wave. Such changes may be temporary and disappear from the cardiogram after recovery, or they may be a sign of incipient atrial hypertrophy.

During an ultrasound examination of the heart muscle, it is possible to detect increased pressure and also measure the volume of blood that is in different parts of this organ. This study also makes it possible to identify disorders in all parts of the heart and in large vessels.

Some conditions may require cardiac surgery, mainly valve replacement, so an ultrasound examination of the heart is mandatory in all patients where overload is detected.

The prognosis of the disease and the correct and timely initiation of treatment depend on the timeliness of the diagnosis.

Treatment and prognosis

If the appearance of overload of the right atrium is associated with the appearance of pneumonia, with an attack of bronchial asthma and other acute conditions, then these changes go away on their own after the underlying disease is cured.

When it comes to chronic diseases, both from the heart and blood vessels, and from the lungs, it is no longer possible to completely get rid of these chronic diseases. It is necessary to reduce the burden on the cardiovascular system by treating exacerbations of these diseases. Treatment of chronic bronchitis will help reduce pressure in the blood vessels of the lungs, and overload of the heart can be avoided.

Most often, signs of overload of the right atrium appear after the ventricle enlarges, and this process ends with the formation of a “pulmonary heart.”

When such changes occur, the onset of heart failure is inevitable, rhythm disturbances and arterial hypertension may occur. Following changes in the right side of the heart, an enlargement of the left side of the heart appears, and heart failure progresses.

Considering all of the above, if signs of right atrium overload are detected on the electrocardiogram, it is necessary to find out the cause of this condition, perform an ultrasound of the heart, and x-ray of the lungs. Treatment of the identified underlying disease should begin as early as possible, before the process becomes chronic and “cor pulmonale” appears.

Brief information: Signs of right atrium overload on the electrocardiogram, especially if these changes are the only ones and are not combined with other changes in the heart, sometimes help to suspect an acute process in the lungs.

dlyaserdca.ru

Term "overload" implies dynamic ECG changes that appear in acute clinical situations and disappear after the patient’s condition normalizes. ECG changes are usually in the ST segments and T waves.

Left ventricular overload

The cause of overload of the left ventricle can be: long-distance running, intense training in athletes, physical overexertion, hypertensive crisis, attack of cardiac asthma... In these cases, the following is observed on the ECG in most cases:

in the left chest leads V5, V6 - a decrease in the ST segment and a flattening or negative T wave;
in leads I, aVL, overload of the left ventricle can manifest itself with a horizontal electrical axis of the heart;
in leads III, aVF, overload of the left ventricle can manifest itself when the electrical axis of the heart is vertical.

Right ventricular overload

The cause of overload of the right ventricle can be: pneumonia, an attack of bronchial asthma, in an asthmatic condition, acute pulmonary failure, pulmonary edema, acute pulmonary hypertension... In these cases, the following is observed on the ECG in most cases:

in the right precordial leads V1, V2 - a decrease in the ST segment and a flattening or negative T wave;
sometimes these ECG changes are determined in leads II, III, aVF.

Systolic and diastolic ventricular overload

Systolic overload(resistance overload) of the ventricles occurs when there is an obstacle in the way of expulsion of blood from the ventricles that impedes blood flow (narrowing of the outlet from the ventricle; increased pressure in the pulmonary or systemic circulation). In such cases, the ventricle contracts, overcoming external resistance in systole, and its hypertrophy develops (ventricular dilatation is mild).

Diastolic overload(volume overload) of the ventricle occurs as a result of its overflow with blood, while overflow of the ventricle with blood in diastole is observed with an increase in the amount of residual blood in it. The cause of diastolic overload is valve insufficiency or increased blood flow, resulting in an increase in diastolic filling and muscle fiber length, leading to increased contractions of the ventricle. With diastolic overload, dilatation of the ventricle mainly occurs (hypertrophy is mild).

Left ventricular systolic overload

Common causes of left ventricular systolic overload:

aortic stenosis;
hypertonic disease;
symptomatic and arterial hypertension;
coarctation of the aorta.

ECG signs of left ventricular systolic overload:

qV5,V6< 2 mm;
high R V5,V6 > R V4 with deep S V1,V2;
the ST segment V5,V6 is located below the isoline, the T wave V5,V6 is negative (similar changes in the ST segment and T wave are usually observed in leads I, aVL);
the activation time of the left ventricle in leads V5, V6 is increased and exceeds 0.04 s.

Right ventricular systolic overload

Common causes of right ventricular systolic overload:

pulmonary stenosis;
pulmonary hypertension;
pulmonary heart;
mitral stenosis.

ECG signs of systolic overload of the right ventricle:

high R V1,V2 (R V1 ≥ S V1), a high late R wave is often observed in lead aVR;
the ST segment V1,V2 is located below the isoline, the T wave is negative (similar changes in the ST segment and T wave are often observed in leads II, III, aVF);
deviation of the electrical axis of the heart to the right;
the activation time of the left ventricle in leads V1, V2 is increased and exceeds 0.03 s.

Diastolic overload of the left ventricle

Common causes of left ventricular diastolic overload:

aortic valve insufficiency;
severe mitral valve insufficiency;
ventricular septal defect.

ECG signs of left ventricular diastolic overload:

q V5,V6 > 2 mm, but less than a quarter of the R wave V5,V6 and less than 0.03 s;
high R V5,V6 > R V4 with deep S V1,V2;
the ST segment V5,V6 is located on the isoline or slightly higher, the T wave V5,V6 is positive (often high and pointed).

Diastolic overload of the right ventricle

Common causes of right ventricular diastolic overload:

severe tricuspid valve insufficiency;
atrial septal defect.

A sign of diastolic overload of the right ventricle on the ECG is the appearance in leads V1, V2 of complete or incomplete blockade of the right bundle branch:

The ECG looks like rsR" or rSR";
The electrical axis of the heart is usually deviated to the right.

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