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Right ventricular dilatation: echocardiographic differential diagnosis

  • Review Article–Cardiology
  • Published:
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Abstract

The initial means of detecting right ventricular (RV) dilatation is often transthoracic echocardiography (TTE), and once the presence of RV dilatation is suspected, there is the possibility of RV volume overload, RV pressure overload, RV myocardial disease, and even nonpathological RV dilatation. With respect to congenital heart disease with RV volume overload, defects or valvular abnormalities can be easily detected with TTE, with the exception of some diseases. Volumetric assessment using three-dimensional echocardiography may be useful in determining the intervention timing in these diseases. When the disease progresses in patients with pulmonary hypertension as a result of RV pressure overload, RV dilatation becomes more prominent than hypertrophy, and RV functional parameters predict the prognosis at this stage of maladaptive remodeling. The differential diagnosis of cardiomyopathy or comparison with nonpathological RV dilatation may be difficult in the setting of RV myocardial disease. The characteristics of RV functional parameters such as two-dimensional speckle tracking may help differentiate RV cardiomyopathy from other conditions. We review the diseases presenting with RV dilatation, their characteristics, and echocardiographic findings and parameters that are significant in assessing their status or intervention timing.

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Abbreviations

ARVC:

Arrhythmogenic right ventricular cardiomyopathy

ASD:

Atrial septal defect

CMR:

Cardiac magnetic resonance

LV:

Left ventricle, left ventricular

Qp/Qs:

Pulmonary to systemic blood flow ratio

RV:

Right ventricle, right ventricular

TAPSE:

Tricuspid annular plane systolic excursion

3D:

Three-dimensional

TOF:

Tetralogy of Fallot

TR:

Tricuspid regurgitation

TTE:

Transthoracic echocardiography, transthoracic echocardiographic

2D:

Two-dimensional

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

    Michiyo Yamano, Tetsuhiro Yamano & Satoaki Matoba

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  1. Michiyo Yamano
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  2. Tetsuhiro Yamano
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  3. Satoaki Matoba
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Correspondence to Michiyo Yamano.

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Yamano, M., Yamano, T. & Matoba, S. Right ventricular dilatation: echocardiographic differential diagnosis. J Med Ultrasonics (2024). https://doi.org/10.1007/s10396-023-01399-4

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