What can cause the right ventricle to enlarge and how serious is this?

Hello,

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I have gone through the reports (attachments removed to protect the patient's identity). Echocardiography is a very operator-dependent test and the value may vary from operator to operator and even with the same operator over different times. Your overweight and obesity itself can cause left ventricular hypertrophy and dilatation. The most common cause of left ventricular hypertrophy is hypertension. Severe left ventricular hypertrophy causes diastolic heart failure. Symptoms are shortness of breath, cough, etc. You have been diagnosed with N- terminal pro-brain natriuretic peptide (NT-proBNP) levels in the blood. You do not have symptoms so you do not have heart failure. Moreover, your echocardiogram does not show signs of diastolic dysfunction. I suggest losing weight and maintaining normal blood pressure near 120/80 mmHg. Better assessment can be done if you can answer the following questions. Can you tell me what your family history is? Who had a heart issue in the family? What did they actually have? Also, please share your electrocardiogram report. I hope I have answered your query.

Hi,

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Right ventricular enlargement has many causes, including chronic obstructive pulmonary disease, smoking, pulmonary embolism, sleep-disordered breathing, which is common in obese people, and pulmonary hypertension. Your echocardiogram report tells that you have a bifascicular block. Blocks plus left ventricular hypertrophy can occur in cardiac sarcoidosis, which can be diagnosed on cardiac biopsy or cardiac magnetic resonance. Signs of right ventricular failure are abdominal distension, feet swelling, and neck veins engorgement. The corrected QT interval is prolonged, probably due to the right bundle branch block; I do not know if they have also corrected it for the bundle branch block or just for heart rate. An echocardiogram report needs to be seen to comment on it.

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Sir, as you are asymptomatic, I would have done nothing now. I would have suggested to lower your weight, control blood pressure and to repeat echocardiography after six months. If you had symptoms or signs of cardiac issue or worsening heart block or cardiac dysfunction, I would have suggested cardiac magnetic resonance imaging for suspected cardiac sarcoidosis. Your echocardiogram shows only moderate right ventricular enlargement, normal right ventricular function, and tricuspid annular plane systolic excursion of 29 mm is normal (less than 17 mm is abnormal). Your echocardiogram also shows mild to moderate left ventricular wall thickening but left ventricular function is normal. At this stage my approach would be just wait and watch.

Hi,

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Yes, symptoms may occur late. However, many times cardiac size returns to normal . There are many causes of right ventricular dilatation, including the history of myocarditis, pulmonary embolism, pulmonary hypertension, arrhythmogenic right ventricular cardiomyopathy, etc. I suggest you to take antihypertensive medicines that reduce blood pressure and also prevent cardiac remodeling. But if a patient is anxious, I suggest cardiac magnetic resonance imaging.