right ventricular enlargement

Right ventricular enlargement (also known as right ventricular dilatation (RVD)) can be the result of a number of conditions, including:

• pulmonary valve stenosis
• pulmonary arterial hypertension
• atrial septal defect (ASD) 
• ventricular septal defect (VSD)
• tricuspid regurgitation
• dilated cardiomyopathy
• anomalous pulmonary venous drainage
• tetralogy of Fallot

Clinical presentation

ECG

• right axis deviation
• secondary repolarization (ST-T) abnormalities (leads V1-3)
• deep S waves in lateral (I, aVL, V5-6) leads
• tall, prominent R waves in lead V1
  • may be masked in the presence of COPD

Radiographic features

Plain radiograph

Frontal view demonstrates:

• rounded left heart border
• uplifted cardiac apex

Lateral view demonstrates:

• filling of the retrosternal space
• rotation of the heart posteriorly

Echocardiography

On transthoracic echocardiography the apical 4 chamber (A4C) view allows a qualitative assessment of the presence or absence of right ventricular enlargement, as well as the degree of severity :

• mild RV enlargement
  • basal diameter increased (>4.2 cm)
  • left ventricular size still exceeds that of the RV
• moderate RV enlargement
  • the size of the RV approximates that of the left ventricle (LV)
  • the left ventricle still forms apex
• severe RV enlargement
  • the RV forms the apex and is larger than the LV

Siehe auch:

• Atriumseptumdefekt
• pulmonale Hypertonie
• Dilatative Kardiomyopathie
• left ventricular enlargement
• vergößerter linker Vorhof
• cardiac chamber enlargement
• Normale Herzkonfiguration im Röntgen-Thorax
• Vergrößerung rechter Vorhof