RVDilatation

RVDilatation, also called right ventricular dilatation, is the enlargement of the right ventricle (RV) of the heart. It reflects structural remodeling in response to chronic pressure overload (as from pulmonary hypertension or right-sided heart disease) or chronic volume overload (for example, severe tricuspid regurgitation) or intrinsic myocardial disease. It is typically assessed by imaging, with echocardiography and cardiac magnetic resonance imaging (MRI) providing measurements of RV size and function.

Common causes include pulmonary arterial hypertension and chronic lung disease with cor pulmonale, left-sided heart disease increasing pulmonary pressures, congenital heart diseases such as Eisenmenger syndrome, right ventricular infarction, tricuspid regurgitation, and recurrent pulmonary embolism. Pathophysiology involves an initial dilation to maintain stroke volume, followed by progressive deterioration of contractile function, dilation of the tricuspid annulus with worsening regurgitation, and adverse interventricular interactions.

Diagnosis relies on imaging: echocardiography assesses RV dimensions, fractional area change, and parameters such as TAPSE; the RV to LV size ratio on imaging is informative; MRI is considered the reference method for accurate RV volumes. Electrocardiography and chest imaging can support assessment, while clinical signs include right-sided congestion (elevated jugular venous pressure, edema).

Management focuses on treating the underlying cause and reducing RV afterload or volume overload. Therapies may include treatment of pulmonary hypertension, diuretics for congestion, management of valvular disease, and, in advanced cases, consideration of advanced heart failure therapies or transplantation. Prognosis worsens with greater RV dilation and impaired function, and serial imaging is used to monitor progression.