Why does right ventricular hypertrophy occur in right bundle branch block
Reading File
Finding Sources
Finding Sources
Searching PubMed
"right bundle branch block" AND "right ventricular hypertrophy"
Searching the Web
right bundle branch block right ventricular hypertrophy cause association review
Reading File
Right ventricular hypertrophy (RVH) does not usually occur because of right bundle branch block (RBBB).
More often, both findings reflect an underlying right-sided heart or pulmonary disorder:
-
Raised right-ventricular pressure or volume load causes RVH, for example:
- Pulmonary hypertension or chronic lung disease (cor pulmonale)
- Pulmonary embolism, especially acute right-heart strain
- Congenital heart disease, such as atrial septal defect
- Pulmonary valve or pulmonary artery obstruction
-
The increased pressure/volume stretches, enlarges, or remodels the right ventricle and may affect its conduction tissue, including the right bundle branch. This can delay right-ventricular activation and produce RBBB.
So the usual causal direction is:
Pulmonary/right-heart disease -> RV pressure or volume overload -> RVH and possible RBBB
RBBB itself is an electrical conduction delay. It changes the ECG pattern but does not make the right-ventricular muscle hypertrophy. It can also occur in an otherwise structurally normal heart. Harrison's notes that RBBB may occur without structural heart disease, but may also accompany congenital and acquired cardiac disease. RBBB overview similarly notes that chronically raised right-sided pressure, such as in cor pulmonale, can stretch the right bundle branch.
One ECG caveat: RBBB can make ECG diagnosis of RVH less reliable, because it changes the right-precordial QRS complexes. Confirm suspected RVH with echocardiography, rather than ECG alone.
This is a shared conversation. Sign in to Orris to start your own chat.