Ventricular Hypertrophy
Ventricular hypertrophy is a condition where the walls of the heart’s ventricles thicken. It can affect the left ventricle, the right ventricle, or both ventricles at the same time Biventricular Hypertrophy.
Left Ventricular Hypertrophy
Causes of Ventricular Hypertrophy
High blood pressure
High blood pressure can overwork the heart muscle, causing the walls to thicken.
Aortic stenosis
Aortic stenosis is a condition where the aortic valve narrows, which can overwork the heart muscle.
Thickened septum
A thickened septum can narrow the passageway between the ventricles, forcing the ventricles to pump harder.
Symptoms of Ventricular Hypertrophy
Shortness of breath, especially when lying down
Swelling in the legs
Chest pain, particularly during exercise
Palpitations, which feel like a rapid, fluttering, or pounding heartbeat
Fainting or lightheadedness
Left Ventricular Hypertrophy is seen in
(1) Hypertension,
(2) Aortic valve disease,
(3) Idiopathic Hypertrophic Subaortic Stenosis,
(4) Coarctation of aorta.
Right ventricular hypertrophy occurs in
(1) Pulmonary stenosis
(2) Pulmonary hypertension
(3) ASD, VSD, PDA
(4) TOF
Biventricular Hypertrophy is seen in
Cardiomyopathy, PDA, VSD, MR with pulmonary hypertension.
Diagnosis of Ventricular Hypertrophy in ECG
1.Voltage criteria in ECG
R in V1 = S in LIII > 25mm
R in a VL > 12 mm
R in a VF > 20 mm
R in V5 / V6 > 26 mm
R V5 / V6 + SV1 > 35 mm
2.Romihilt Scoring system
(a) R or S in limb Leads > 20 mm or R in V5 / V6 > 30 mm-3 points
(b) ST depression ——————————————2 points
(c) QRS duration ( > 0.09 sec)——————————1 point
(d) Left axis enlargement——————————– —3 points
(e) Left axis deviation (> – 300)—————————–2 points
(f) Intricoid deflection in V5/V6 > 0.05 second————–1point
When score is 5 or above LVH is definite.
Right ventricular hypertrophy
VAT > 0.03 in V1, persistent wide S wave in V5 V6,
QR in V1 or V3 R are suggestive of RVH
Other suggestive features of RVH are: RV1>7 mm, R/S in VI > 1, ST depression and T inversion in V1.
Biventricular Hypertrophy
LVH by voltage criteria with ST depression and T wave inversion in V1-V2.
Treatment for Ventricular Hypertrophy
Blood pressure medication: Can help prevent the condition from worsening
Heart valve surgery: Can be used to replace a narrowed valve
Lifestyle changes: Eating well and exercising regularly can help lower blood pressure and reduce
Complications of Ventricular Hypertrophy
Complicated Arrhythmias,
Myocardial fibrosis,
Heart failure,
Heart attack,
Stroke.
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