HomeAnswersCardiologyright ventricular hypertrophyHow can I develop right ventricular hypertrophy (RVH) in just four months?

What are the causes of right ventricular hypertrophy (RVH) developed in just four months?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. K. Shobana

Published At June 30, 2022
Reviewed AtAugust 2, 2023

Patient's Query

Hello doctor,

I just had an echocardiogram that showed LVH (left ventricular hypertrophy), RVH (right ventricular hypertrophy), and RAE (right atrial enlargement). Four months ago, an echo only showed LVH, and the right side was normal. My LVEF (left ventricular ejection fraction) is 55 to 60. This new echo also showed mild systolic dysfunction in the right ventricle. Is this heart failure? How could it change so much in four months? Kindly provide your insight.

Hello,

Welcome to icliniq.com.

I read your query and understood your concern. The reason for your condition is your high BMI (body mass index), which measures 42.4. Your ideal weight should be between 145 to 170 pounds. This obesity is causing strain on the right side of your heart and mild systolic dysfunction. I suggest you follow a strict weight loss program as it will undoubtedly be beneficial for you. It appears to be heart failure with preserved ejection fraction, and it is possible that you have gained a significant amount of weight over the past four months. Additionally, I suggest you get your thyroid profile checked. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

The Probable causes

The probable cause is obesity.

Investigations to be done

Investigations to be done are thyroid profile and serum cortisol test.

Differential diagnosis

The differential diagnosis is chronic pulmonary thromboembolism.

Probable diagnosis

The probable diagnosis is right ventricular dysfunction secondary to morbid obesity.

Treatment plan

The treatment plan is weight loss.

Patient's Query

Thank you for the reply doctor,

At this stage, is all of this reversible? Is it life-threatening? It appears to be progressing rapidly since only four months ago, there was only LVH. Could this be pulmonary hypertension? I understand that weight loss can have a positive impact on everything. I have not experienced any swelling or edema, but I do get dizzy when bending over or being active for a short period. I also have right atrial enlargement. Kindly help.

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. It is reversible. Your tricuspid annular plane systolic excursion is 2.9, indicating that the right ventricle is still functioning normally. Therefore, weight loss should be beneficial. Obese individuals often have increased chamber pressures and volumes, which is likely causing right atrial enlargement. At this point, pulmonary hypertension does not appear to have developed, but the values you provided do not include the pulmonary artery pressures. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Thank you doctor for the reply,

I have attached my reports. Kindly review them.

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. I have reviewed your attached reports (attachments removed to protect the patient's identity), It seems you have a heart failure with preserved ejection fraction. The resting blood pressure is normal, but as you mentioned, it increases when you are active. That is why your doctor prescribed Losartan, a drug that helps with blood pressure. The dosage is kept very low. I suggest you continue with the weight loss plan and a graded exercise program, which will also help stabilize your blood pressure during exercise. With progress, there might be a chance to gradually reduce and eventually discontinue the use of Losartan. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Thank you for the reply doctor,

So how quickly does this progress? I am 38 years old, and I just need the truth. I am asymptomatic currently. Is this something that in two years will be a huge issue? How long does it take before the left ventricle starts wearing out after enlarging? And does the right side involvement mean I am in worse shape for prognosis? If this is already heart failure, it sounds like the progression is moving quickly. Kindly help.

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. I would like to inform you that with good control of blood pressure, as you have now, the condition will not progress rapidly. Usually, it takes decades before it increases in severity, particularly concerning shortness of breath. This disease progresses very slowly. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Vivek S Narayan Pillai
Dr. Vivek S Narayan Pillai

Cardiology

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