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Signs and treatment of right atrial hypertrophy. Right atrium overload what is it Predominance of the right atrium causes

From this article you will learn: what is right atrial hypertrophy, what is the mechanism of its development. Types of hypertrophy, causes of occurrence and characteristic symptoms. Distinctive signs of right atrium hypertrophy on the ECG, treatment and prognosis.

Article publication date: 08/14/2017

Article updated date: 06/02/2019

Hypertrophy (thickening of the chamber walls) of the right atrium is not a heart disease, but a characteristic symptom, the result of cardiovascular pathologies or regular physical activity (the norm for professional athletes).

Against the background of certain pathological processes (tricuspid valve stenosis, increased pressure in the pulmonary arteries), the filling and pressure in the right atrium becomes excessive. To ensure normal blood flow and protect the chamber from rupture, the myocardium builds up layers (thickens), and the strength and frequency of atrial contractions increases.

As a result, the patient develops arrhythmia, and characteristic symptoms of venous congestion in the lungs appear - cough, asthma-like shortness of breath.

Pathology always appears against the background of diseases (pulmonary, cardiovascular), blood flow disorders in the systemic or pulmonary circulation (the exception is working hypertrophy - thickening of the myocardial layer in response to regular physical activity, “athlete’s heart”).

It can be cured completely if the cause of hypertrophy is eliminated in time (for example, tricuspid valve stenosis, pulmonary disease), the thickness of the muscle walls decreases, the functions of the heart are restored (the strength of atrial contractions decreases, the heart rhythm normalizes).

If the cause cannot be eliminated, over time such thickening may become more complex to:

heart rhythm disturbances (supraventricular extrasystole);
formation of cor pulmonale (dysfunction of the right ventricle due to pathologies in the pulmonary vessels);
congestion (venous insufficiency);
lead to death as a result of pulmonary embolism.

Treatment for pathology is prescribed by a cardiologist.

Mechanism of development and types of hypertrophy of the right atrium

With defects of the tricuspid valve (this is the three-cuspid septum between the right atrium and the ventricle), the opening through which blood normally flows freely from the atrium into the ventricle is greatly narrowed or does not close enough. This disrupts intracardiac blood flow:

after filling the ventricle at the time of diastole (relaxation), an extra portion of blood remains in the atrium;
it puts more pressure on the myocardial walls than during normal filling and provokes their thickening.

With pathology in the pulmonary circulation (pulmonary diseases), blood pressure in the pulmonary vessels and in the right ventricle increases (the pulmonary or pulmonary circulation begins from there). This process prevents the free flow of the required volume of blood from the atrium into the ventricle; part of it remains in the chamber, increases pressure on the walls of the atrium and provokes the growth of the muscular layer of the myocardium.

Diagram of the pulmonary and systemic circulation. Muscle layer of the myocardium. Click on photo to enlarge

Most often, right atrial hypertrophy develops against the background of cardiovascular disorders, but sometimes it becomes a consequence of regular physical activity or myocardial necrosis.

Depending on the factor under the influence of which the thickening of the chamber walls appeared, there are:

Regenerative hypertrophy due to scarring at the site of necrosis (after a heart attack). The atrial myocardium grows around the scar, trying to restore cell function (conduction and contraction).
Replacement as a way for the heart muscle to compensate for circulatory deficiencies under the influence of various pathologies and negative factors.
Working – a form that develops under the influence of regular physical activity (professional training), as a protective mechanism for increased heart rate, hyperventilation of the lungs, increased pumped blood volume, etc.

Working hypertrophy is typical not only for athletes, but also for people with heavy physical labor (miners).

Causes of pathology

The causes of right atrial hypertrophy can be	Factors against which pathology develops faster
Any chronic diseases (obstructive bronchitis, pneumonia, bronchial asthma)	Arterial hypertension
Myocardial infarction	Obesity
Valve defects (tricuspid, pulmonary artery)	Constant nervous tension
Heart defects (, atrial septal defects)
Congenital or acquired vascular defects (pulmonary stenosis)
Right ventricular hypertrophy (increased load due to congenital defect, tetralogy of Fallot)

Characteristic symptoms, signs on ECG

In the initial stages, until severe heart failure (impaired heart function and blood supply to organs and tissues) occurs, hypertrophy is asymptomatic, without affecting the quality of life.

Over time, signs of pulmonary congestion begin to appear - shortness of breath, coughing and tingling in the heart, fatigue with moderate exertion.

Subsequently, if the process progresses, other changes in the heart muscle join the hypertrophy of the right ventricle (dilatation of the ventricle, cor pulmonale, disturbance of blood supply, rhythm and function of the heart), typical pronounced ones appear - shortness of breath with little physical activity and at rest, reduced working capacity to full disability.

Symptoms often appear some time after suffering pulmonary diseases (bronchitis, pneumonia).

Signs of RA hypertrophy on the ECG

An informative diagnostic method for determining pathology is electrocardiography; characteristic signs of right atrium hypertrophy do not appear:

sharpening and increasing the height of the P wave (this way the excitation of the atria is recorded; normally the P wave is flat with a rounded apex);
an increase in the amplitude (width of the image on paper) of the P wave (normally does not exceed 0.2 seconds, graphically displayed using large cells on ECG paper).

Right atrial hypertrophy on the ECG. Click on photo to enlarge

To confirm ECG data, the doctor may prescribe other diagnostic methods - duplex ultrasound scanning, which can be used to assess the degree of hypertrophy and other changes in the heart (dilatation of the right ventricle, increase in overall size).

Treatment methods

Right atrial hypertrophy can be cured completely if the cause that caused it occurs is eliminated in time. In some cases, the pathology goes away on its own, after recovery (for pulmonary diseases).

Treatment is chosen depending on the disease and the reasons that led to its appearance:

when the pressure in the pulmonary vessels increases, vasodilator bronchodilators, anti-inflammatory, antiarrhythmic agents that improve the metabolism of the heart muscle are prescribed;
for congenital or acquired defects of the heart, valves or blood vessels, surgical correction of the defect is performed.

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Forecast for life

The prognosis for the development of pathology depends entirely on the underlying disease (or complex of pathologies) against which it appeared. If hypertrophy is diagnosed in the early stages, before irreversible changes in the heart (dilatation of the right atrium) have yet occurred and the cause is easy to eliminate (for example, tricuspid valve stenosis), the pathology can be cured completely.

If hemodynamic disturbances (the movement of blood inside the heart and through the vessels) have become pronounced, it will be more difficult to eliminate the pathology. Under such conditions, hypertrophy of the right atrium is quickly accompanied by changes in other chambers of the heart (dilatation of the right ventricle), arrhythmia, heart failure and impaired blood supply develop, first in the pulmonary and then in the systemic circulation.

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.

Cardiac surgeon

Higher education:

Cardiac surgeon

Kabardino-Balkarian State University named after. HM. Berbekova, Faculty of Medicine (KBSU)

Level of education - Specialist

Additional education:

Certification cycle for the Clinical Cardiology program

Moscow Medical Academy named after. THEM. Sechenov

Right atrial hypertrophy (RAH) occurs as a result of serious disorders in the pulmonary circulation, respiratory system, or is caused by valve pathology. The cause of hypertrophy or thickening of the walls of the atrium can also be a congenital heart defect. Pathological changes in the right atrium must be detected in time, which will allow the cause to be diagnosed and immediate treatment to begin.
Enlargement of the right chamber of the heart with constant physical activity and active life is considered normal. And there should not be a cause for concern, since it is not dangerous to human life and health.

Reasons

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. Usually, 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.

Right atrial hypertrophy is a disease in which this part of the heart enlarges. This problem usually affects the left atrium, as it experiences more stress. It is considered normal if cardiac volume increases in athletes. In other cases, cell proliferation is a pathology. Hypertrophy is not an independent disease, but a syndrome that develops as a result of some kind of deficiency.

There are many causes of right ventricular hypertrophy

Reasons for rejection

Changes in the size of the atrium often develop as a result of congenital disorders of the heart. But this problem can also arise due to:

overweight;
narrowing of the mitral valve, while the left atrium can fill with blood, causing it to expand (it needs to make more effort to pump blood, which can also lead to an increase in volume);
hypertrophic cardiomyopathy;
stress;
high blood pressure.

If the pressure in the blood vessels is high, the heart has to work harder. This negatively affects its atria, which at the same time stretch and increase in size. This condition is dangerous for human health and life, because the walls of the heart stretch, become less elastic and the functioning of the organ gradually deteriorates.

The reasons for enlargement of the right atrium are different. This can occur with diseases of the lungs, blood vessels, and heart defects formed during intrauterine development. These pathologies lead to increased pressure in the pulmonary artery. The heart is forced to work hard to overcome high pressure and its atria experience severe stress, as a result of which hypertrophic changes occur and failure develops.

This condition may result from:

Pathologies of the respiratory system that lead to increased pressure. For example, bronchitis.
Narrowing of the tricuspid valve. It is responsible for the passage of blood from the right atrium to the ventricle. If the size of this opening decreases, then the amount of blood passing from the atrium into the ventricle decreases. To restore normal blood circulation, the atrium has to make more effort to squeeze blood into the ventricle, which leads to increased load.
Presence of tricuspid valve insufficiency. In this case, blood is transfused from the ventricle into the atrium.

Congenital heart disease.
With hypertrophic changes in the left ventricle, the right ventricle enlarges.

Atrial overload develops at a very rapid pace. These changes can be clearly seen on the ECG.

Symptoms of pathology

Right atrium hypertrophy manifests itself depending on the degree of impairment. Most patients suffer from chest pain, severe fatigue and breathing problems. These symptoms often appear after pneumonia, a period of exacerbation of bronchial asthma, or pulmonary embolism. After the underlying disease is cured, the manifestations of hypertrophy decrease or disappear altogether. In addition to signs of pulmonary diseases, symptoms of congestion in the veins may occur.

With an increase in the size of the right atrium, the patient suffers from:

cough, shortness of breath, deterioration of respiratory function;
swelling;
cyanosis and pale skin;
attention disorders;
stabbing pain in the heart, discomfort in the chest;
heart rhythm disturbances.

Very often, with hypertrophy there are no symptoms. The disease begins to appear in advanced stages. Therefore, if you are concerned about dizziness, increased heart rate, or swelling of the extremities, you need to visit a specialist and undergo an examination.

ECG changes

The main method of examination for suspected hypertrophy is electrocardiography (ECG). If there is an increased load on the right atrium, the electrical axis shifts to the right, forward and down.

The presence of hypertrophic changes can be judged by the following signs:

Sharpening and increasing the height of the positive phase of the tooth.
The first positive phase prevails over the negative one.
Widening and lengthening of the P wave.

An increase in the volume of the atrium on the right is determined by the signs of p pulmonale on the ECG. They also characterize pathological conditions of the lungs, the chronic form of cor pulmonale, and increased pressure in the pulmonary artery.

Possible complications

With this pathology, blood flow is disrupted, which leads to a decrease in the amount of oxygen entering the body. As a result of these disorders, the pressure in the vessels of the lungs increases, the right atrium begins to actively contract and subsequently increases in size.

Hypertrophic changes in the atrium on the right often cause:

expansion of the heart;
blood flow disturbances in both circles;
development of pulmonary heart syndrome;
stagnation of venous blood;
swelling of the limbs;
blue discoloration of the skin;
shortness of breath.

As the disease progresses, disruptions in the functioning of all vital organs occur.

If signs of hypertrophy of the right atrium are noticeable on the ECG and this occurred as a result of malfunctions of vital organs, then the prognosis for this pathology is based on the characteristics of the course of the underlying disease and the success of its treatment. It all depends on the severity of the changes in the tissues of the heart. If hypertrophy occurs as a result of a defect and the atrium and ventricle are enlarged, then surgical treatment may be necessary.

In case of defects acquired after infectious diseases, the defects can be eliminated using conservative therapy. The outcome of hypertrophy depends on the severity of the defects, the presence of other diseases, the general condition of the patient’s body, and the severity of circulatory disorders.

If the diagnosis was made in the early stages of development, the treatment was competent and the patient complies with all the doctor’s instructions, then even with hypertrophy you can count on a normal life. The main thing is to seek help from specialists in a timely manner.

Necessary examinations

If right atrial hypertrophy was detected on the ECG, the patient is referred for additional studies that will confirm the diagnosis and establish its causes. Diagnosis of the disease consists of the following steps:

Examination at an appointment with a cardiologist.
Echocardiography. It can be performed during pregnancy, young children and the elderly. The procedure is performed using professional equipment that allows you to visualize the structure of the entire heart, measure its volume and wall thickness.
Dopplerography and color Doppler scanning. They provide detailed hemodynamic information.

Sometimes electrocardiography does not provide accurate information that matches the symptoms. In this case, they may seek help from radiography or computed tomography. These studies provide an accurate picture of the condition of the heart, which can be used to identify any problems that may arise.

X-ray examination cannot be performed on all patients. It is prohibited during pregnancy.

Treatment methods

If the atrium has increased in size, it means that there are problems in the body that led to this deviation. Therefore, it is possible to eliminate changes and improve the supply of oxygen to the body by normalizing heart functions only by eliminating the main cause of pathological disorders. The following methods are usually used:

Complex therapy for the underlying disease is prescribed.

The patient must change his lifestyle. He should give up alcohol and smoking, limit the consumption of salt, liquids, and foods high in cholesterol, lose excess weight if such a problem exists, and normalize physical activity. Thanks to this, you can speed up the healing process and avoid recurrence of the problem.
In the presence of pulmonary heart syndrome as a result of diseases of the respiratory system, it is necessary to compensate for pulmonary function with the help of medications that have anti-inflammatory and bronchodilator properties.
In case of valve defects, surgery cannot be avoided.
To improve well-being, symptomatic treatment is prescribed, which consists of the use of antiarrhythmic drugs, cardiac glycosides, and drugs to stimulate metabolic processes in the heart muscle.

Overload of the right atrium on the ECG is not a death sentence if treated in a timely manner. This will completely get rid of the problem and prevent complications.

To avoid the development of such violations it is necessary:

maintain a proper daily routine and eat healthy foods;
avoid bad habits;
avoid a sedentary lifestyle and excessive physical activity;
play sports, take daily walks in the fresh air, preferably before bedtime;
avoid nervous strain, since as a result of stress the heart quickly wears out; to strengthen the nervous system, you can do yoga, meditation, and auto-training.

Deviations can be detected in a timely manner if you undergo examination at least once every six months. If you have diseases that can cause complications on the circulatory system and heart, it is necessary to undergo treatment promptly and completely. Maintaining the health of the whole organism plays an important role in the prevention of hypertrophic changes.

Hypertrophic changes can develop in any organ that contains muscle fibers, but most often this occurs in the heart. The heart muscle, or myocardium, is designed in such a way that with increasing load on it, that is, with increasing effort to perform the pumping function, the number of myocytes (muscle cells) increases, as well as the thickening of the muscle fiber. Typically, such changes affect those areas that are most susceptible to overload, or in which normal muscle tissue is replaced by scar tissue. In the latter case, the myocardial zones around the scar tissue thicken compensatoryly so that the heart as a whole can pump blood.

parts of the heart and hypertrophy

Hypertrophy can involve both muscle in all parts of the heart and in individual chambers (in the wall of the atria or ventricles). Each type of myocardial hypertrophy has its own causes.

Why does hypertrophy of the right atrium myocardium occur?

Enlargement of the right atrium is rarely isolated, that is, it is almost always combined with hypertrophy of other parts of the heart (usually). It usually develops due to overload of the right atrium myocardium due to high pressure or increased volume.

In the first case, the muscle fibers constantly have difficulty pushing blood into the right ventricle through the tricuspid (three-leaf) valve. In the second case, the myocardium of the right atrium is constantly overstretched if blood from the right ventricle is refluxed into the atrial cavity (under normal conditions this should not happen). That is, hypertrophy develops gradually, gradually in cases where the causative disease remains undetected and untreated for a long time. The time this process may take varies individually - in some patients, hypertrophy can form within a few months from the onset of the disease, in others the myocardium remains in a normal state for decades. But in any case, the compensatory abilities of the heart (to carry out an increased load) sooner or later weaken, the heart becomes exhausted, and decompensation develops.

Diseases that can trigger the development of myocardial hypertrophy are the following:

1. Pathology of the bronchopulmonary system

In severe cases of certain diseases, for example, bronchial asthma (especially hormone-dependent), chronic obstructive bronchitis, emphysema, frequent recurrent pneumonia, bronchiectasis, hypertrophy of the myocardium of the right ventricle first develops, and subsequently the right atrium.

2. Pathology of the right heart

In this case, we are talking about defects of the tricuspid valve - its insufficiency or stenosis of its opening. With insufficiency of the valve ring, volume overload of the atrium on the right occurs, since with each contraction of the heart, blood does not completely flow from the atrium into the ventricle, and part of it is thrown back. This process is called regurgitation. As a result, with each contraction the atrium receives an increased amount of blood (a portion of blood obtained from the vena cava, which carries blood from the entire body into the cavity of the right atrium, as well as a portion of blood thrown back from the ventricle), and its wall is overstretched. The myocardium becomes thicker and stronger - hypertrophy develops.

With stenosis of the right atrioventricular orifice, the situation is different. As a result of the fact that the valve ring becomes narrower than normal, the myocardium of the right atrium has to work with greater load - pressure overload of the myocardium occurs. After some time, the heart muscle thickens, and the atrium cavity increases, since not all the blood can be pushed out in one heartbeat into the cavity of the right ventricle.

3. Pathology of the pulmonary artery and its valve

The pulmonary artery is a large vessel that arises from the right ventricle and carries blood flow to the lungs to saturate it with oxygen. With congenital pathology of the pulmonary artery valve, called , it is more difficult for the right ventricular myocardium to push blood into the lumen of the artery, as a result of which it hypertrophies. Then hypertrophy of the right atrium gradually increases.

4. Myocardial remodeling

This process implies the development of post-infarction, due to which scar tissue forms in place of the necrotic heart muscle. The remaining portion of normal cardiomyocytes gradually thickens, leading to compensatory hypertrophy. Typically, this process involves the left ventricle, but in rare cases, right ventricular infarction may develop, as a result of which remodeling also affects the wall of the right atrium.

5. Postmyocardial cardiosclerosis

The formation of scar tissue in this case is due to inflammatory changes in the heart muscle, or. Myocarditis can be caused by viruses, fungi or bacteria, and inflammation can develop in the muscle of any of the chambers of the heart. Several months or years after the inflammation, compensatory hypertrophy of the right atrium myocardium develops if it is damaged.

6. Coronary heart disease

Acute or chronic lack of oxygen in the heart muscle, caused by blockage of the coronary artery with an atherosclerotic plaque or thrombus and being the pathogenetic basis for, leads to disruption of the contractile function of those cardiomyocytes that are susceptible to these processes. At the same time, neighboring areas of the myocardium thicken compensatoryly. A moderate increase in the myocardium of the right atrium is formed when the blockage is localized in the lumen of the artery that supplies the atrial heart muscle.

7. Hypertrophic cardiomyopathy

It is a disease resulting from genetic defects and is characterized by uniform thickening of the myocardium. is more often recorded in young children and can involve the myocardium of the right atrium.

What are the signs of right atrial hypertrophy?

The symptoms of this pathology can remain blurred for a long time, since the symptoms of the underlying disease (lung disease, heart attack, myocarditis, etc.) come to the fore. However, patients experience the following symptoms:

Shortness of breath during physical activity or at rest, dry hacking cough (due to stagnation of blood in the pulmonary circulation and),
Heaviness in the right side and periodic pain in the right hypochondrium (caused by increased blood supply in the liver and overstretching of its capsule),
Swelling of the lower extremities, increasing in the morning, after a long horizontal position of the body,
Feeling of heart failure,
Paroxysms of atrial fibrillation and supraventricular tachycardia, provoked by improper functioning of the sinus node located in the right atrium appendage, as well as by incorrect and chaotic contractions of overstretched and thickened muscle fibers of the right atrium.

The occurrence of any of the listed symptoms, especially in persons with existing heart or lung pathology, requires immediate consultation with a doctor for examination and additional diagnostics.

How to diagnose right atrial hypertrophy?

In order to confirm or exclude this pathology in a patient, the doctor, in addition to a clinical examination, prescribes examination methods such as:

Echo-CS, (echocardioscopy, or), which allows you to visualize the heart and its internal structures, as well as clarify the type of defect, if any,
X-ray examination of the organs of the chest cavity, which visualizes changes not only in the right atrium, but also in the right ventricle (the contour of the atrium merges with the contours of the superior vena cava, pulmonary artery and the contour of the right ventricle).

The main routine research method is an electrocardiographic study, which is used to determine the following signs of right atrium hypertrophy on the ECG:

An increase in the amplitude and width of the P wave (above 2.5 mm and wider than 0.1 sec) - the so-called P-pulmonale (high, pointed, biphasic),
The P wave is higher and wider along the right chest leads (V1, V2),
The electrical axis of the heart is deviated to the right or sharply to the right.

Video: ECG signs of hypertrophy of the right atrium and other chambers of the heart

Treatment of right atrial hypertrophy

This pathology is a fairly serious problem that requires treatment of the causative disease. In most cases, when the provoking factor is eliminated, the right atrium muscle ceases to experience constant overload and can return to normal size. Among the therapeutic measures used to treat causative diseases, the following can be noted:

Competent and timely treatment of pulmonary pathology (use of inhalers for bronchial asthma, antibacterial therapy for pneumonia, surgical treatment for bronchiectasis, etc.).
Timely surgical correction of heart defects.
Prevention of myocardial remodeling after infarction and myocarditis using drugs with antihypoxic and cardioprotective effects. The first group includes antihypoxants such as Actovegin, Mildronate, Mexidol and Preductal. From the second group, antihypertensive drugs are prescribed - ACE inhibitors or angiotensin II receptor antagonists (ARA II). They significantly reduce the rate of myocardial hypertrophy and are able to delay the development of chronic heart failure. Enalapril, quadripril, perindopril, etc. are usually prescribed.
Complex treatment of coronary heart disease. Nitroglycerin, beta-blockers (metoprolol, bisoprolol, nebivalol, etc.), ACE inhibitors, antiplatelet agents that prevent blood clots (aspirin) and lipid-lowering drugs that normalize cholesterol levels in the blood (statins) are mandatory.

Regarding the treatment of myocardial hypertrophy itself, it should be noted that they significantly reduce the development of decompensation of heart failure with hypertrophy of the right heart.

Forecast

If we talk about the consequences of right atrium hypertrophy, it is worth noting that the natural course of the process, without treatment, inevitably leads to severe chronic heart failure. The heart of such patients is not able to withstand normal household activities. They often experience severe heart rhythm disturbances and attacks of acute heart failure, which can cause death. If the causative disease is successfully treated, then the prognosis for right atrial hypertrophy becomes favorable, and the quality and life expectancy increase.