What is Right Ventricular Hypertrophy ECG?

There are several tests to diagnose right ventricular hypertrophy; in case of suspicion the ECG is an easy, quick, cheap and useful test. The sensitivity of electrocardiographic criteria in cases of right ventricular hypertrophy is questionable in some cases it is helpful and is used in advanced diagnostic studies.

The electrocardiogram (ECG) is a test that records the electrical activity of the heart. The results are printed on a graph paper.

The electrocardiogram registers in that paper the changes that appear in the small electrical currents that occur in the heart with each beat. In order to perform this test, the patient must lie down to place the electrodes on each arm, on both legs and on the thorax. The electrocardiograph cables are connected to the patient’s skin by means of adhesives or suction cups (electrodes) attached to the ankles, wrists and chest of the patient. In this way, the same electrical impulse is collected from different positions.

This electrical activity is recorded from the patient’s body surface and is drawn on a paper by means of a graphic representation or layout, where different waves representing electric stimuli of the auricles and ventricles are observed. The device with which an electrocardiogram is done is termed as electrocardiograph. For the collection of electrical activity by the electrocardiograph, it is necessary that a series of electrodes (usually 10) are placed on the patient’s skin, which will be attached to the electrocardiograph by wires. With 10 electrodes, 12 derivations are obtained, that means that 12 tracings of the electrical impulses of the heart are drawn on the paper from different points of the body. Extra derivations can be obtained if more electrodes are added to the body surface, but the basic electrocardiogram should have minimum of 12 derivations. The electrocardiogram of a healthy person presents a particular outline. When changes appear in that outline, the doctor can determine if there is a problem.

The patient should remain relaxed during the test, without speaking, with a normal breathing rhythm and with immobile arms and legs. The electrocardiogram test is absolutely painless. When the electrodes are applied for the first time you may feel some cold. In extremely rare circumstances, the patient may develop a localized rash or irritation in the area where the electrodes are placed.

ECG is an essential test for the analysis of arrhythmias, study of heart diseases and it’s especially useful in acute instances of coronary disease like a myocardial infarction. It is used to measure the rhythm and regularity of beats, the size and position of the auricles and ventricles, any heart damage, and what effect does certain medications or devices implanted in the heart like a pacemaker have.

Right ventricular hypertrophy develops when the walls of the right ventricle become thick as a result of increased pressure exerted on them.

There are various medical conditions that may put pressure on the right ventricle resulting in right ventricular hypertrophy and is associated with significant mortality and morbidity.

There are several electrocardiographic criteria to detect right ventricular hypertrophy, which can offer a non-invasive, well-tolerated and inexpensive screening method. But these criteria have an uncertain accuracy in patients without known cardiovascular disease.

Cardiac hypertrophy is characterized by an increase in the individual size of the myocytes (muscle cells) and an expansion of the extracellular matrix in response to mechanical, hemodynamic, neurohumoral, hormonal or pathological stimuli. Myocytes and fibroblasts act as biomechanical sensors that express embryonic genes that lead to physiological hypertrophy, concentric hypertrophy, eccentric hypertrophy or apoptosis (programmed cellular death).

Diagnosis is performed from the signs and symptoms (clinical diagnosis) and confirmed by diagnostic images, radiology, echocardiography and electrocardiogram which will indicate LVH if the combined values of S-wave in V1 and R-wave in V5-V6 is more than 3.5 mV. Otherwise, it will be a right ventricular hypertrophy.

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