What does increased activity of the right atrium mean. Hypertrophy of the right atrium: features of the disease, main symptoms and methods of treatment. ECG changes

Enlargement of any of the chambers of the heart with thickening of the heart muscle leads to heart failure. Hypertrophy of the right atrium occurs when blood flow through the pulmonary artery is disturbed and is manifested by the expansion of the cavities of the right side of the heart. Symptoms indicate an underlying disease, and cardiac changes are detected by electrocardiography or sonography. With the right approach to the treatment of the disease that caused hypertrophic changes, the function of the heart will improve, and the size of the atrium will return to normal.

Causal factors for enlargement of the right chambers of the heart

A change in the wall thickness and dilatation of the internal cavity of the right atrium appear with an increase in load: venous blood is collected in the right parts of the heart, which enters the pulmonary circulation through the pulmonary artery and is saturated with oxygen in the lungs.

Hypertrophy of the right heart is almost always secondary changes, therefore, with timely treatment of the primary pathology, there will be no serious problems in the atrium and ventricle.

Possible Complications

Dilatation of the cavity of the right atrium with thickening of the myocardial wall in the absence of adequate therapy can cause the following dangerous complications:

chronic heart failure;
progressive;
and violation of conduction by the type of blockade;
complete;
myocardial infarction;
sudden cardiac death.

Combination therapy and long-term medical supervision are the best option for treatment tactics: with the right approach to treatment, deadly complications can be prevented, reduce the size of the heart and significantly improve the quality of life of a sick person.

Hypertrophy of the right atrium is called a disease in which there is an increase in this part of the heart. This problem usually affects the left atrium, as it experiences more stress. It is considered normal if the 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

A change in the size of the atrium often develops as a result of congenital disorders of the heart. But this problem can also occur because of:

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 vessels is high, then 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 are stretched, become less elastic and the work of the organ is gradually deteriorating.

The reasons for the increase in the right atrium are different. This can occur with diseases of the lungs, blood vessels, heart defects formed in the process of 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 strong stresses, as a result of which hypertrophic changes occur and insufficiency 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 hole decreases, then the amount of blood passing from the atrium to the ventricle also decreases. To restore normal blood circulation, the atrium has to make more efforts to squeeze blood into the ventricle, which leads to an increase in the load.
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, an increase in the right ventricle occurs.

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

Symptoms of pathology

Hypertrophy of the right atrium manifests itself depending on the degree of violations. Most patients suffer from pain in the chest, experiencing severe fatigue and respiratory failure. These symptoms often appear after pneumonia, a period of exacerbation of bronchial asthma, 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 stagnant processes 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;
edema;
cyanosis and pallor of the skin;
attention disorders;
stabbing pains in the heart, discomfort in the chest;
cardiac arrhythmias.

Very often, with hypertrophy, there are no symptoms. The disease begins to manifest itself in advanced stages. Therefore, if you are worried about dizziness, increased heart rate, swelling of the limbs, 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, then 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.
Broadening and lengthening of the R wave.

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

Possible Complications

With such a pathology, blood flow is disturbed, 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 cardiac departments;
blood flow disturbances in both circles;
development of cor pulmonale syndrome;
stagnation of venous blood;
swelling of the extremities;
blueing of the skin;
shortness of breath.

With the development of the disease, disturbances occur in the work of all vital organs.

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

With defects acquired after infectious diseases, the violations can be eliminated with the help of conservative therapy. The outcome of hypertrophy depends on the severity of defects, the presence of other diseases, the general condition of the patient's body, 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 prescriptions, 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, then the patient is sent for additional studies that will confirm the diagnosis and establish its causes. Diagnosis of the disease consists of the following steps:

Seeing 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 whole 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 would match the symptoms. In this case, they may seek help from x-rays or computed tomography. These studies provide an accurate picture of the condition of the heart, which can be used to identify abnormalities that have arisen.

X-ray examination may not be performed for all patients. It is prohibited during pregnancy.

Treatment Methods

If the atrium has increased in size, then 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 due to the normalization of heart functions only by eliminating the main cause of pathological disorders. The following methods are usually used:

Assign complex therapy of the underlying disease.

The patient must change his lifestyle. He should give up alcohol and smoking, limit the intake of salt, liquids, foods high in cholesterol, get rid of excess weight, if there is such a problem, and normalize physical activity. Thanks to this, you can speed up the healing process and avoid the 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 medicines that have anti-inflammatory and bronchodilatory properties.
With valve defects, surgical intervention is indispensable.
To improve well-being, symptomatic treatment is prescribed, which consists of the use of antiarrhythmic drugs, cardiac glycosides, drugs to stimulate metabolic processes in the heart muscle.

Overloading the right atrium on the ECG is not a 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:

observe the correct daily routine and eat healthy food;
avoid bad habits;
avoid a sedentary lifestyle and excessive physical exertion;
play sports, take daily walks in the fresh air, it is advisable to do this before going to bed;
avoid nervous overstrain, since as a result of stress the heart wears out quickly, to strengthen the nervous system, you can do yoga, meditation, auto-training.

Deviations can be detected in time if you undergo an examination at least once every six months. In the presence of diseases that can give complications to the circulatory system and heart, it is necessary to undergo treatment in a timely manner and to the end. An important role in the prevention of hypertrophic changes is played by maintaining the health of the whole organism.

Many people are interested in what right atrial hypertrophy is. This is a rather serious anomaly, which is accompanied by an increase in this fragment of the heart. In athletes, this phenomenon may be a variant of the norm. In other people, it is considered a pathology. It should be borne in mind that hypertrophy cannot be considered an independent disease. It becomes one of the symptoms of another ailment.

Right atrial hypertrophy is a rather dangerous disease, which is often associated with hereditary disorders. This means that the disease is often passed on to children from their parents. The following are also considered the key causes of the anomaly:

There are other causes of HPP:

bad habits - smoking or drinking alcohol can lead to problems;
the presence of excess weight;
chest injury;
neuroses, stressful situations;
physical overload;
previous myocardial infarction or myocarditis;
congenital deformities of the skeleton;

Classification of atrial hypertrophy

The type of right atrial enlargement depends on the cause of the development. There are several types of hypertrophy:

Symptoms of the disease

There are no specific signs of atrial hypertrophy. All symptoms are due to the presence of developing heart failure. In this case, you should pay attention to such manifestations:

shortness of breath at rest and during movement;
discomfort and pain in the left side of the chest;
cough at night;
periodic appearance of a sensation of deviations in the rhythm of the heart;
violation of respiratory functions - they become more intense when the patient lies down;
swelling of the limbs;
severe pallor of the skin;
violation of vascular tone, the development of hypertension;
increased fatigue.

Important: To avoid dangerous health consequences, it is necessary to detect heart pathology as early as possible. Therefore, it is strictly forbidden to ignore the listed symptoms.

In some situations, hypertrophy has an asymptomatic development. The disease manifests itself only in advanced cases. Therefore, the appearance of deviations in the rhythm of the heart, swelling of the limbs or dizziness should be the reason for an urgent appeal to a specialist.

Diagnosis and signs on the ECG

To determine the causes of the disease, the cardiologist conducts such studies:

questioning the patient - the specialist should study the history of the disease;
palpation - the doctor presses on specific areas of the body to detect abnormal changes;
percussion - the procedure involves tapping in the area of \u200b\u200bthe heart;
auscultation - is to listen to the rhythm of the heart.

It is possible to reveal hypertrophy of the right atrium not only on the ECG. To do this, the following instrumental procedures are carried out:

Right atrial hypertrophy on ECG

With this diagnosis, an increase in the excitation vector of the right atrium is observed. When performing an electrocardiogram, the appearance of a high P wave can be detected. ECG signs of hypertrophy include the following:

the height of the abnormal P wave is more than 2-2.5 mm;
the apex of the abnormal P wave is usually symmetrical;
the width of the abnormal P wave remains normal - sometimes this parameter increases to 0.11-0.12 s;
an abnormally high P wave is recorded in standard leads II, III and enhanced lead aVF.

In the case of the development of hypertrophic changes in the right atrium, there is a deviation of the electrical axis of the P wave to the right side. Typical symptoms of an abnormal P wave when such a pathology occurs include the following:

There is a deep pointed P wave in lead aVR. It is negative. As a rule, its width does not change.
In the I standard lead, it is negative or smoothed. More rarely, a pointed P wave is diagnosed in leads I, aVL.
In lead V1, the P wave is sometimes weakly positive, flattened, or weakly negative. However, in leads V2 and V3 it is tall and spiky.
In chest assignments V1 and V2 the high pointed tooth is observed. It can also be two-phase with a noticeable predominance of the positive phase. In the normal state, the P wave is biphasic smoothed.
The more pronounced hypertrophy, the more chest leads there is a high and pointed P wave. In this case, it is positive. Leads V5, V6 are characterized by a decrease in the P wave in amplitude.

Treatment of GPP

When right atrial hypertrophy is detected, it is necessary to determine how to treat this anomaly. The treatment regimen should be selected by the doctor, taking into account the cause of the development of the disease. The most commonly used methods are:

Forecast and possible consequences

The prognosis is determined taking into account the cause of the development of pathology and the timeliness of contacting a doctor. If irreversible changes have not occurred in the myocardium, and the provoking factor can be eliminated, the person can be completely cured.

If you do not start therapy in time or ignore the symptoms of pathology, it leads to dangerous health consequences. These include the following:

Doctors say that, provided that the disease is detected in a timely manner and adequate therapeutic measures are taken, this violation does not pose a danger to the patient's health.

Prevention

To avoid the occurrence of the disease, you need to follow a number of recommendations:

adhere to a healthy lifestyle;
control the mode of work and rest;
to refuse from bad habits;
do sport;
rational and balanced diet;
refuse excessive physical activity;
avoid hypodynamia;
walk in the fresh air - it is recommended to do this in the evening;
avoid stressful situations, as they lead to rapid wear of the heart;
doing meditation or yoga - this will help strengthen the nervous system.

In order to timely identify the symptoms of the disease, you need to systematically undergo a medical examination. It is recommended to do this at least once every six months. If a person has anomalies that can lead to problems with blood circulation and deterioration of the heart, it is worth starting therapy immediately.

Atrial hypertrophy is a dangerous deviation that can cause all sorts of complications. To prevent this, it is worth contacting a doctor at the first manifestations of the disease. The cardiologist will conduct a detailed examination and select the optimal therapy, taking into account the provoking factor of the pathology.

Do you have any questions? Ask them in the comments! They will be answered by a cardiologist.

Content

Thickening of the walls of the chamber (hypertrophy) of the right atrium (RAA) is not a disease, but a symptom of any cardiovascular pathology or the result of regular physical activity (for athletes). The disease is diagnosed with an ECG. If the cause of the pathological process is eliminated in a timely manner, then hypertrophy is completely curable.

Causes of right atrial hypertrophy

The disease occurs against the background of pathological processes, due to which the filling of the right atrium (RA) with blood becomes excessive. To ensure normal blood flow and to protect the chamber from rupture, the myocardium builds up layers, as a result of which the frequency and strength of its contractions increase. GPP can develop with a strong emotional outburst, due to deformity of the ribs, obesity or addiction to alcohol. The reasons for the thickening of the PP are:

pulmonary pathologies (obstructive pulmonary disease, bronchitis);
heart defects (congenital);
stenosis of the bicuspid valve;
pulmonary embolism;
insufficiency of the tricuspid valve;
enlargement of the right ventricle.

Hypertrophy is classified by type. They are distinguished, depending on the factors that affect the work of the heart:

A working HPP develops against the background of constant overstrain or intense loads of a healthy person.
Replacement is the result of the adaptation of the heart to the normal regimen in various pathological conditions of the main organ.
Regenerative HPP develops after a myocardial infarction, when a scar is formed, and the functions of the lost zone are taken over by cardiomyocytes (muscle cells of the heart) that have grown around.

Clinical symptoms

The main signs of PP overload are soreness in the chest and respiratory problems. Often, symptoms are preceded by pneumonia, pulmonary embolism, bronchial asthma, and other pathologies. After treatment of the underlying disease, signs of hypertrophy may completely disappear. The following clinical symptoms will help to recognize GPP:

puffiness;
shortness of breath, worsening of breathing, cough;
skin pallor, cyanosis;
pathology of the heart rhythm;
tingling discomfort in the region of the heart;
severe fatigue with moderate exertion.

Signs of hypertrophy on the ECG

The rhythm of the heart muscle creates an electric field that has a positive and negative pole. The difference of these potentials is recorded on the ECG in the allotted electrodes, which are previously attached to the patient's chest and limbs. The electrocardiograph registers the changed signals coming in a certain period of time, after which it displays them on paper in the form of a graph.

The atrial complex of the electrocardiogram in PP hypertrophy is called P pulmonale on the ECG. As a rule, it is observed in patients with chronic lung pathologies, tricuspid stenosis, repeated thromboembolism. The main signs of right atrial overload on the ECG:

pulmonary (pulmonary) P wave;
increase in the right atrial part P;
pointed and high P in 2 and 3, aVF leads.

Offset electrical axis to the right

In the normal position of the axis, the angle between the electrodynamic activity vector and the horizontal coordinate is 30-70°. In thin people and asthenics, the angle value of 90 ° is considered the norm. For dense and short people, the normal figure is from 0 to 30 °. Studying the data of right atrial hypertrophy on the ECG, the diagnostician can see a sharp deviation of the axis to the right up to 120 °. This condition of the patient is not a pathology, but may indicate that the right ventricle and / or right atrium is abnormally enlarged, which indicates diseases such as:

ischemia;
stenosis of the pulmonary artery;
mitral valve stenosis;
atrial fibrillation;
atrial septal defect, etc.

"Lung Heart"

The revealed hypertrophy of the right atrium on the ECG is a sign of such a pathology as cor pulmonale. So in cardiology they call a complex of symptoms that occur with high pressure in a small circle of blood flow. The causes of the development of cor pulmonale are various lesions of the respiratory system. About 80% of diseases of the lungs and bronchi provoke this disease. Signs of the development of cor pulmonale on the ECG:

vertical location of the electrical axis or deviation to the right;
the presence of P pulmonale (signs of overload of the right heart);
pronounced S wave or a decrease in its amplitude;
RV6/SV62 ratio;
registration of the S wave in all chest leads from V1 to V6;
decrease in the ST segment and negative T wave in leads V1, V2;
the presence of QRV1 (with the exclusion of focal myocardial damage).

Treatment

The goal of all therapeutic methods is the normalization of the work of the heart muscle. After right atrial hypertrophy is detected on the ECG, the patient is individually prescribed drug therapy, limit physical activity to moderate, and recommend an anti-cholesterol diet. The basis of treatment is the following groups of drugs:

Antianginal agents. Reduce the preload on the myocardium, improve blood circulation in the subendocardial sections of the heart muscle (Nitroglycerin, Mildronate).

Antihypoxants. Medicines that improve the utilization of oxygen circulating in the body, increase resistance to oxygen deficiency (hypoxia). It is prescribed for GPP to prevent myocardial remodeling (Actovegin, Preducal).
Cardioprotective drugs. They help strengthen the heart muscle, reduce the concentration of toxins in the body, accelerate cell regeneration, and prevent the formation of blood clots. Cardioprotectors are divided into several groups: statins (Acorta, Crestor), beta-blockers (Atenolol, Anaprilin, Metoprolol, Bisoprolol), antiplatelet agents (Aspirin C, Curantil).
Antihypertensive drugs. They reduce the rate of myocardial hypertrophy, and also help to delay the development of heart failure in the chronic stage. Antihypotensive agents are divided into several subgroups: ACE inhibitors (Enalapril, Quadropril, Perindopril), angiotensin 2 receptor antagonists (Angiakand, Lozap).

The heart consists of four compartments - two atria and two ventricles, which, by contracting, pump blood around the body. The walls of these chambers are formed by a muscle layer - the myocardium, which, under excessive load, can thicken - hypertrophy, this can be seen during an ECG. Thickening of the left side of the heart is more common, as they are under greater stress, but there is also hypertrophy of the right side, in particular right atrial hypertrophy.

1 Why does the right atrium "get fat"?

The heart pumps blood around the body. From the atria through the openings, blood enters the ventricles, and then is pushed into the vessels. The right atrium is able to accommodate a certain volume of blood, if this volume exceeds the allowable one for some reason, the muscle tissue of the heart begins to work more actively in order to expel this excess volume, defense mechanisms are triggered and the muscle tissue grows - it hypertrophies, the walls of the atrium thicken - so they are easier to handle.

This condition is right atrial hypertrophy. All the causes leading to hypertrophy can be divided into two large groups: heart disease and lung disease. Let's take a closer look at these reasons:

2 What are the symptoms of hypertrophy?

In the early stages, as a rule, the patient does not suspect that his right atrium is "gaining" mass. Its increase can only be observed on the ECG. there may be complaints of shortness of breath during physical activity, sometimes at rest, weakness, cough, increased pulsation of the neck veins. With the formation of circulatory failure in a large circle, there is heaviness under the rib on the right, the edge of the liver, swelling and pastosity of the feet, ankles, and abdomen can be felt.

Complications that occur when the enlarged and enlarged right side of the heart can't do its job are heart failure and chronic cor pulmonale.

3 Helpers in the diagnosis of hypertrophy

A doctor can recognize hypertrophy by an ECG. There are certain signs by which the doctor can recognize atrial enlargement. So, ECG signs: the P wave, which on the cardiogram is responsible for the work of the atrium, in leads II, III, avF becomes high, pointed, more than 2.5 mm in height. The P wave is also called P-“pulmonale” in another way, in the ECG leads v1, v2 it becomes two-hump or two-phase.

The electrical axis of the heart is deviated to the left. Suspecting hypertrophy on the ECG, the doctor will prescribe an echocardiogram. An echocardiogram will show an increase in the thickness of the myocardium or an increase in the size of the atrium. On the radiograph, there may be an increase in the shadow of the right heart. It should be noted that changes on the ECG in the form of an increase in the amplitude of the P wave can be observed in tall, thin young people. This is a variant of the norm.

4 Overload or hypertrophy. How to distinguish?

It is necessary to distinguish such concepts as right atrial overload and right atrial hypertrophy. The difference is that overload is a symptom, for the most part, short-term and passing, it is a condition that occurs acutely (with exacerbation of bronchial asthma, pneumonia, heart attack). Overload can also be observed with endocrine disorders - thyrotoxicosis, with tachycardia. With atrial overload, the ECG will have the same symptoms as with hypertrophy. But when an acute attack is removed, or after a cure, when the patient's condition improves and the causes go away, all symptoms and ECG signs disappear and the cardiogram returns to normal.

5 How to treat a hypertrophied atrium?

Since hypertrophy is not a disease, but just a symptom of a particular disease, the disease that caused the enlargement of the heart is treated. If hypertrophy is caused by bronchial asthma or chronic obstructive pulmonary disease, treatment should be correctly selected to reduce the frequency of exacerbations and transfer these diseases into remission. If hypertrophy occurred due to violations of the tricuspid valve, measures should be taken to normalize its work.

Thus, by acting on the underlying disease, it is possible, if not eliminated, then to prevent the progression of the growth of the atrial myocardium. The patient, in turn, is required to give up bad habits (smoking, alcohol), balance nutrition, avoid spicy, salty foods, adhere to the regime of work and rest, control body weight. The doctor gives recommendations for treatment and adherence to a healthy lifestyle individually and in each case. The only general rule for all patients: strict adherence to the doctor's recommendations.