Enlarged ventricles on the electrocardiogram (ECG)

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What is it about ?

The heart is made up of chambers, that is, two atria and two ventricles. We have a right and a left atrium, as well as a right and a left ventricle. The wall of one or both cavities may thicken. Usually, an underlying cause of this thickening (called an enlargement) is detected, but not always.

An enlarged wall of the left ventricle is usually due to hypertension). The high blood pressure causes the heart muscle (the myocardium) to pump harder, and it thickens. Yes hypertension persists for a long time, the heart muscle becomes enlarged and damaged.

But a poor function of the heart valves can also be the cause of an enlarged left ventricle.

The hypertrophic cardiomyopathy (MHC) is an inherited heart disease, which is characterized by abnormal thickening of the muscle of the heart of unknown origin.

Some sportsmen Professionals who practice intensive daily workouts may also develop an enlarged myocardium.

An enlarged ventricle may also be associated with an increased risk ofcoronary artery disorders, such as angina, a myocardial infarction) and sudden death.

A thickening of the wall of the right ventricle always indicates serious underlying heart or lung disease.

How is the diagnosis made?

The doctor will give you an EKG (ECG) in case of’hypertension uncontrolled or hear a murmur when you auscultate your heart and suspect a heart valve disease.

Since the ECG is not a very sensitive test (i.e., its ability to detect disease is not very high), the doctor will give a ultrasound of the heart (echocardiography) in the following cases, even in the absence of suggestive changes to the ECG:

  • if he suspects a thickening of the heart muscle;
  • if the desired blood pressure is not reached.

A echocardiography is a technique used to assess the anatomy and function of the heart using sound waves. This is the most reliable way to get an accurate picture of an enlarged right ventricle.

What can you do ?

The thickening of the heart muscle goes away by eliminating the cause of the problem.

In case of hypertrophy of the left ventricle, blood pressure is controlled with medication (below 130/80 mm Hg). If the thickening decreases, this indicates that the blood pressure management is correct. The hypertrophies also normalize after have successfully operated on a malfunctioning valve.

Since an enlarged right ventricle suggests serious disease of the heart or lungs, these tests and treatment require the intervention of a specialist.

Sources

Foreign clinical practice guide ‘Evaluation of ventricular hypertrophies on ECG’ (2000), updated on 01.03.2017 and adapted to the Belgian context on 23.10.2019 – ebpracticenet

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