Skip to Main Content
Home Books Multimodal Cardiovascular Imaging: Principles and Clinical Applications

Chapter 19. Right Ventricular Cardiomyopathies

Vincent L. Sorrell; Julia H. Indik; Nishant Kalra; Frank I. Marcus

  • Sections
  • Print
  • Get Citation

    Citation

    AMA Citation
    Sorrell VL, Indik JH, Kalra N, Marcus FI. Sorrell V.L., Indik J.H., Kalra N, Marcus F.I. Sorrell, Vincent L., et al.Chapter 19. Right Ventricular Cardiomyopathies. In: Pahlm O, Wagner GS. Pahlm O, Wagner G.S. Eds. Olle Pahlm, and Galen S. Wagner.eds. Multimodal Cardiovascular Imaging: Principles and Clinical Applications New York, NY: McGraw-Hill; 2011. http://accesscardiology.mhmedical.com/content.aspx?bookid=382&sectionid=40663672. Accessed October 16, 2019.
    MLA Citation
    Sorrell VL, Indik JH, Kalra N, Marcus FI. Sorrell V.L., Indik J.H., Kalra N, Marcus F.I. Sorrell, Vincent L., et al.. "Chapter 19. Right Ventricular Cardiomyopathies." Multimodal Cardiovascular Imaging: Principles and Clinical Applications Pahlm O, Wagner GS. Pahlm O, Wagner G.S. Eds. Olle Pahlm, and Galen S. Wagner. New York, NY: McGraw-Hill, 2011, http://accesscardiology.mhmedical.com/content.aspx?bookid=382&sectionid=40663672.

    Download citation file:

    RIS (Zotero)
    EndNote
    BibTex
    Medlars
    ProCite
    RefWorks
    Reference Manager
    Mendeley
    © Copyright
  • Tools
  • Search Book
  • Clip
Top

The evaluation of right ventricular (RV) size and function in normal and pathologic conditions is challenging due to its complex shape and nonsymmetrical contraction. Unlike the left ventricle (LV), the RV is crescent shaped and truncated, with separate inflow and outflow portions. The normal RV is triangular (curved) when viewed sagittally, crescent shaped when viewed axially, and similar to a teapot when viewed coronally (Fig. 19–1). It is thin walled, highly trabeculated, and devoid of the LV's extensive circumferential myofibrillar architecture. The RV apex may be dominated by the shape and function of the LV apex or may be entirely separate and independent ("butterfly" apex) (Fig. 19–2).1 The RV is strongly influenced by the normally concave interventricular septum, and its shape is influenced by acute and chronic pathologic pressure and volume changes. Whereas the normal LV has the shape of a prolate ellipse (and becomes a sphere in many disease states), there is no convenient model that accurately approximates normal or pathologic RV geometry.

Figure 19–1.
Image not available.
View Full Size|Favorite Figure|Download Slide (.ppt)
Image not available.
Image not available.
View Full Size|Favorite Figure|Download Slide (.ppt)
Image not available.
Image not available.
View Full Size|Favorite Figure|Download Slide (.ppt)
Image not available.
Image not available.
View Full Size|Favorite Figure|Download Slide (.ppt)
Image not available.

Representative cardiac magnetic resonance (CMR) white blood images. The normal right ventricle (RV) is crescent shaped when viewed axially (A), triangular (curved) when viewed sagittally (B and C), and similar to a teapot when viewed coronally (D).

Figure 19–2.
Image not available.
View Full Size|Favorite Figure|Download Slide (.ppt)
Image not available.
Image not available.
View Full Size|Favorite Figure|Download Slide (.ppt)
Image not available.

A. Cardiac magnetic resonance imaging white blood (steady-state free precession) cine image. The right ventricular (RV) apex is entirely separate and independent from the left ventricular (LV) apex ("butterfly" apex; black arrow). Left. Diastole. Right. Systole. Note the thin hypokinetic RV apex in this normal patient (white arrow). B. Importance of foreshortening. This is a normal volunteer without heart disease. Note the left panel images (a = diastole; b = systole) that were obtained within minutes of the right panel images (c = diastole; d = systole). The image on the left was obtained with a slightly inferior angulation relative to the truly aligned four-chamber view on the right creating a foreshortened LV long axis diameter (dotted lines equal length). Due to the pyramidal RV shape, this inferior angulation creates an elongated RV cavity relative to the LV. This creates a falsely dilated RV cavity and also accentuates the RV apex, which appears separated from the LV ("butterfly") and hypokinetic (arrows). See Moving Image 19–2B.

Vedio Graphic Jump Location
Moving Image 19-2B.

Importance of foreshortening.

Image not available.
Play Video

This chapter describes the unique characteristics of the RV and offers a ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.

This site uses cookies to provide, maintain and improve your experience. MHE Privacy Center Close