Right heart strain: Difference between revisions
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'''Right heart strain''' (or '''right ventricular strain''') is a [[medical finding]] of right ventricular dysfunction<ref>{{Cite web|url=http://radiopaedia.org/articles/right-heart-strain|title=Right heart strain {{!}} Radiology Reference Article {{!}} Radiopaedia.org|last=Weerakkody|first=Yuranga|website=radiopaedia.org|access-date=2016-07-12}}</ref> where it is enlarged and rounder than typical. When normal, the right ventricle is about half the size of the left ventricle; when strained, it can be as large as or larger than the left ventricle.<ref name="Blaivas2014"/> Right heart strain can be caused by [[pulmonary hypertension]],<ref>{{Cite journal|last=Koestenberger|first=Martin|last2=Friedberg|first2=Mark K.|last3=Nestaas|first3=Eirik|last4=Michel-Behnke|first4=Ina|last5=Hansmann|first5=Georg|date=2016-03-01|title=Transthoracic echocardiography in the evaluation of pediatric pulmonary hypertension and ventricular dysfunction|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4860554/|journal=Pulmonary Circulation|volume=6|issue=1|pages=15–29|doi=10.1086/685051|issn=2045-8932|pmc=4860554|pmid=27162612}}</ref> [[pulmonary embolism]] (or PE, which itself can cause pulmonary hypertension<ref name=Predict/>), right ventricular infarction, [[chronic lung disease]], and [[pulmonic stenosis]].<ref name="Blaivas2014">{{cite book|author=Mike Blaivas|title=Emergency Medicine, An Issue of Ultrasound Clinics,|url=http://books.google.com/books?id=ErJXAwAAQBAJ&pg=PA229|date=3 April 2014|publisher=Elsevier Health Sciences|isbn=978-0-323-29021-0|page=229}}</ref> |
'''Right heart strain''' (or '''right ventricular strain''') is a [[medical finding]] of right ventricular dysfunction<ref>{{Cite web|url=http://radiopaedia.org/articles/right-heart-strain|title=Right heart strain {{!}} Radiology Reference Article {{!}} Radiopaedia.org|last=Weerakkody|first=Yuranga|website=radiopaedia.org|access-date=2016-07-12}}</ref> where it is enlarged and rounder than typical. When normal, the right ventricle is about half the size of the left ventricle; when strained, it can be as large as or larger than the left ventricle.<ref name="Blaivas2014"/> Right heart strain can be caused by [[pulmonary hypertension]],<ref>{{Cite journal|last=Koestenberger|first=Martin|last2=Friedberg|first2=Mark K.|last3=Nestaas|first3=Eirik|last4=Michel-Behnke|first4=Ina|last5=Hansmann|first5=Georg|date=2016-03-01|title=Transthoracic echocardiography in the evaluation of pediatric pulmonary hypertension and ventricular dysfunction|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4860554/|journal=Pulmonary Circulation|volume=6|issue=1|pages=15–29|doi=10.1086/685051|issn=2045-8932|pmc=4860554|pmid=27162612}}</ref> [[pulmonary embolism]] (or PE, which itself can cause pulmonary hypertension<ref name=Predict/>), right ventricular infarction, [[chronic lung disease]], and [[pulmonic stenosis]].<ref name="Blaivas2014">{{cite book|author=Mike Blaivas|title=Emergency Medicine, An Issue of Ultrasound Clinics,|url=http://books.google.com/books?id=ErJXAwAAQBAJ&pg=PA229|date=3 April 2014|publisher=Elsevier Health Sciences|isbn=978-0-323-29021-0|page=229}}</ref> |
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It can be visualized on a [[CT scan]] of the chest or through an [[echocardiograph]] (echo) of the heart.{{efn|If visualizing the heart by an ultrasound echo, the apical-four-chamber (A4C) view is best to visualize right heart strain.<ref name="Blaivas2014"/>}} When using echo, the '''McConnell's sign''' is specific for right heart strain and typically indicates a large PE. On an [[electrocardiogram]] (EKG), right heart strain can be indicated through a finding of S1Q3T3.<ref name=Predict>{{Cite journal|last=Shopp|first=Jacob D.|last2=Stewart|first2=Lauren K.|last3=Emmett|first3=Thomas W.|last4=Kline|first4=Jeffrey A.|date=2015-10-01|title=Findings From 12-lead Electrocardiography That Predict Circulatory Shock From Pulmonary Embolism: Systematic Review and Meta-analysis|journal=Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine|volume=22|issue=10|pages=1127–1137|doi=10.1111/acem.12769|issn=1553-2712|pmid=26394330}}</ref> [[Cardiac magnetic resonance]] can also show right heart strain.<ref>{{Cite journal|last=Tadic|first=Marijana|date=2015-12-01|title=Multimodality Evaluation of the Right Ventricle: An Updated Review|url=http://onlinelibrary.wiley.com/doi/10.1002/clc.22443/abstract|journal=Clinical Cardiology|language=en|volume=38|issue=12|pages=770–776|doi=10.1002/clc.22443|issn=1932-8737}}</ref> |
It can be visualized on a [[CT scan]] of the chest or through an [[echocardiograph]] (echo) of the heart.{{efn|If visualizing the heart by an ultrasound echo, the apical-four-chamber (A4C) view is best to visualize right heart strain.<ref name="Blaivas2014"/>}} When using echo, the '''McConnell's sign''' is specific for right heart strain and typically indicates a large PE.<ref>{{Cite journal|last=Walsh|first=Brooks M.|last2=Moore|first2=Christopher L.|date=2015-09-01|title=McConnell's Sign Is Not Specific for Pulmonary Embolism: Case Report and Review of the Literature|url=https://www.ncbi.nlm.nih.gov/pubmed/25986329|journal=The Journal of Emergency Medicine|volume=49|issue=3|pages=301–304|doi=10.1016/j.jemermed.2014.12.089|issn=0736-4679|pmid=25986329}}</ref> On an [[electrocardiogram]] (EKG), right heart strain can be indicated through a finding of S1Q3T3.<ref name=Predict>{{Cite journal|last=Shopp|first=Jacob D.|last2=Stewart|first2=Lauren K.|last3=Emmett|first3=Thomas W.|last4=Kline|first4=Jeffrey A.|date=2015-10-01|title=Findings From 12-lead Electrocardiography That Predict Circulatory Shock From Pulmonary Embolism: Systematic Review and Meta-analysis|journal=Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine|volume=22|issue=10|pages=1127–1137|doi=10.1111/acem.12769|issn=1553-2712|pmid=26394330}}</ref> [[Cardiac magnetic resonance]] can also show right heart strain.<ref>{{Cite journal|last=Tadic|first=Marijana|date=2015-12-01|title=Multimodality Evaluation of the Right Ventricle: An Updated Review|url=http://onlinelibrary.wiley.com/doi/10.1002/clc.22443/abstract|journal=Clinical Cardiology|language=en|volume=38|issue=12|pages=770–776|doi=10.1002/clc.22443|issn=1932-8737}}</ref> |
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==See also== |
==See also== |
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Revision as of 16:06, 9 August 2016
Right heart strain (or right ventricular strain) is a medical finding of right ventricular dysfunction[1] where it is enlarged and rounder than typical. When normal, the right ventricle is about half the size of the left ventricle; when strained, it can be as large as or larger than the left ventricle.[2] Right heart strain can be caused by pulmonary hypertension,[3] pulmonary embolism (or PE, which itself can cause pulmonary hypertension[4]), right ventricular infarction, chronic lung disease, and pulmonic stenosis.[2]
It can be visualized on a CT scan of the chest or through an echocardiograph (echo) of the heart.[a] When using echo, the McConnell's sign is specific for right heart strain and typically indicates a large PE.[5] On an electrocardiogram (EKG), right heart strain can be indicated through a finding of S1Q3T3.[4] Cardiac magnetic resonance can also show right heart strain.[6]
See also
- Pulmonary heart disease (cor pulmonale)
Notes
References
- ^ Weerakkody, Yuranga. "Right heart strain | Radiology Reference Article | Radiopaedia.org". radiopaedia.org. Retrieved 2016-07-12.
- ^ a b c Mike Blaivas (3 April 2014). Emergency Medicine, An Issue of Ultrasound Clinics,. Elsevier Health Sciences. p. 229. ISBN 978-0-323-29021-0.
- ^ Koestenberger, Martin; Friedberg, Mark K.; Nestaas, Eirik; Michel-Behnke, Ina; Hansmann, Georg (2016-03-01). "Transthoracic echocardiography in the evaluation of pediatric pulmonary hypertension and ventricular dysfunction". Pulmonary Circulation. 6 (1): 15–29. doi:10.1086/685051. ISSN 2045-8932. PMC 4860554. PMID 27162612.
- ^ a b Shopp, Jacob D.; Stewart, Lauren K.; Emmett, Thomas W.; Kline, Jeffrey A. (2015-10-01). "Findings From 12-lead Electrocardiography That Predict Circulatory Shock From Pulmonary Embolism: Systematic Review and Meta-analysis". Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine. 22 (10): 1127–1137. doi:10.1111/acem.12769. ISSN 1553-2712. PMID 26394330.
- ^ Walsh, Brooks M.; Moore, Christopher L. (2015-09-01). "McConnell's Sign Is Not Specific for Pulmonary Embolism: Case Report and Review of the Literature". The Journal of Emergency Medicine. 49 (3): 301–304. doi:10.1016/j.jemermed.2014.12.089. ISSN 0736-4679. PMID 25986329.
- ^ Tadic, Marijana (2015-12-01). "Multimodality Evaluation of the Right Ventricle: An Updated Review". Clinical Cardiology. 38 (12): 770–776. doi:10.1002/clc.22443. ISSN 1932-8737.