Hypertrophy of the right atrium( GLP) is not a separate disease, but rather a symptom or consequence of other diseases.
However, the GPP is important to detect on time: it will allow to diagnose the concomitant pathology, and if it is urgently needed to prescribe symptomatic treatment of hypertrophy.
The only case when the GLP should not cause concern is a uniform increase in all parts of the heart due to systematic physical exertion.
Causes of GLP(primary pathologies)
In cardiac practice, the right heart region hypertrophy is less common than the increase in the left .The reason is that, while providing hemodynamics of a large circle of blood circulation, the left ventricle experiences greater loads than the right, pushing blood into a small circle. And overload of the ventricle entails functional changes in the corresponding atrium.
One or more of the following factors may become a cause for increasing the right atrial only:
- acute or chronic pulmonary diseases - obstructive pulmonary disease, pulmonary artery embolism, emphysema, etc.;
- bronchitis, bronchial asthma;
- hypertrophy of the right ventricle( per eq - find out how it looks);
- congenital heart defects;
- acquired valvular defects - stenosis( constriction) and regurgitation( transmission).
Briefly describe the mechanism of their influence on the size of the atria.
Between the right atrium and the ventricle is a tricuspid septum - tricuspid valve. Normally, it remains closed when the ventricle contracts( in the systole phase) and opens at the time of relaxation( in the diastole phase) to fill it with blood coming from the atrium.
Broncho-pulmonary diseases increase pressure in the pulmonary circulation system and, as a consequence, in the right ventricle. Therefore, the blood entering the right atrium does not immediately flow into the ventricle, which provokes the GPP.
In the operation of the three-leaf valve, there may be deviations - structural or functional, congenital or acquired : this may be incomplete closure of the valves in the systole phase or, conversely, a narrowing of the gap between them in the diastole phase.
Clinical symptoms of
. There are no specific, specific symptoms of GLP.The clinical picture is associated mainly with manifestations of primary pathology, but is sometimes supplemented with signs of venous stasis. Patient can complain about:
- uncaused fatigue, retardation;
- shortness of breath or difficulty breathing;
- uneven heart rate;
- short-term pain, tingling in the heart;
- swelling of the legs and abdominal wall;
- is a cyanotic skin color.
If such complaints first appeared against the backdrop of complex infections, exacerbation of asthma, pulmonary embolism or other acute conditions - , there is a possibility that after recovery, the normal cardiac function will recover .To monitor the rehabilitation process, the ECG is performed in dynamics.
Symptoms on the ECG in comparison with the
norm If is suspected on a cardiogram, the
- height and the shape of the R, S prongs in leads I-III and P wave in either lead II, III or aVF are examined;
- direction( up / down) and the width of the tooth base;
- repetition of the drawing( haphazardly or intermittently).
Based on the results, conclusions are drawn about the presence or absence of the following signs of hypertrophy.
EO displacement of the heart to the right
In those cases where the GLP is due to or is associated with right ventricular hypertrophy, an ECG deviation of the electric heart axis to the right can be observed. The normal position of the EO is between 0◦ and 90◦;If the degree measure belongs to the interval 90◦-99◦, a minor deviation of the axis to the right is recorded. At values of 100◦ and above, a significant shift in the axis is indicated.
We will not give a formula for the magnitude of the angle, but we will show you how to "determine by eye" the cardinal direction of the right EO displacement. For this, the should check if the following conditions are met:
- In the 1st lead: the S-wave is negative, R is positive, but its height is less than the depth S.
- In leads II and III: the height of the R wave is an order of magnitude higher than the sameheight in lead I. In addition, when comparing the teeth R in the leads II, III, the latter should be higher.
"Pulmonary Heart"( P-pulmonale)
Pathological changes in the pulmonary( pulmonale) circle of the circulatory system - is the frequent cause of the .On the ECG, they are reflected by modifications of the first( atrial) tooth P.
In normal atrial function, the P tooth has a blunt, flattened tip of the ;but with a GLP in the leads II, III, aVF there is a high pointed "peak".The explanation of this fact is the following: the line of the tooth P is the sum of two peaks - excitations of each of the atria.
- Normally, excitation of PP precedes the initiation of LP;the extinction of excitations takes place in the same manner. The P- and A-curves intersect, and the point of their intersection corresponds to the apex of the "dome" of the tooth P.
- At the GLP, the excitation of the LP occurs after the excitation of the PP, but they decay almost simultaneously. The amplitude of the P-peak is larger, and it completely "absorbs" the A peak - this is reflected in the shape of the total curve.
It should be understood that a combination of P-pulmonale symptoms can be present on the cardiogram not only with hypertrophy, but also with functional overload of PP-this happens, for example, against hyperthyroidism, tachycardia, coronary heart disease, etc.
The EO shift to the right is also not a specific GLP symptom: a slight deviation of the EO from the vertical occurs normally in astenics - tall people of thin build.
To clarify the condition and size of the heart, a physician can, in addition to ECG, apply other techniques.
Additional diagnostics of
If the ECG shows signs of atrial enlargement, the patient is recommended additional examinations to confirm hypertrophy and find out its causes.
The simplest diagnostic methods - percussion( tapping), palpation( feeling) and auscultation( listening) - will be involved already on examination in the cardiologist's office.
From hardware studies, echocardiography ( EchoCG - ultrasound of the heart) is most likely to be prescribed: it is safe for all groups of patients, including the elderly, young children and pregnant women, and is suitable for multiple examinations in dynamics.
Modern echocardiographs use special software for 3D-visualization of the heart structure and its valves;it is possible to measure both functional and physical parameters( in particular, the volume of the parts of the heart, the thickness of the walls, etc.).
Together with Echocardiography in cardiology, dopplerography and color DS ( Doppler scan) are used: these examinations supplement the result of EchoCG with information on hemodynamic characteristics and color image of blood flow.
In rare cases, it is possible that the result of echocardiography does not correspond to clinical manifestations. The fact is that the picture we see on the monitor of the EchoCG device is in reality only a model built by the program based on calculations. And programs, like people, tend to be wrong.
So, if ultrasound does not help determine the diagnosis, prescribe contrast radiography or computed tomography .Both of these X-ray methods make it possible to obtain a reliable image of the heart against the background of other anatomical structures, which is very important for the GLP caused by pulmonary diseases.
Is there a specific treatment for
? The unambiguous answer is no: needs to be treated with pathology, which led to the development of the GP.This may require medication, and in the case of a defect in the heart valves - and surgical treatment.
But sometimes for the normalization of the size of the atria it's enough just to to adjust the way of life:
- to revise the nutrition scheme( in particular, to exclude cholesterol-containing products), to normalize the body weight;
- set the mode of work and rest;
- add uncomplicated regular exercise;
- get rid of bad habits;
- is more in the open air;
- whenever possible, avoid emotional upheavals. Of course, it's easy to find excuses to not do this, but keep in mind: the process can go through a "point of no return", and the increase in the size of the atrium caused by an incorrect regimen will become irreversible.
The main ECG signs of a right atrium increase are now known to you: most likely, you can easily determine if they are present on your electrocardiogram. But since GPP - a secondary and separate treatment, which you could "appoint" in the nearest pharmacy, does not allow to consult a doctor not to pass .Only a cardiologist has sufficient knowledge to determine the primary pathology and the appointment of an adequate treatment.
