Table of ContentsView AllTable of ContentsTypesSymptomsCausesDiagnosisTreatment and PrognosisComplicationsPrevention
Table of ContentsView All
View All
Table of Contents
Types
Symptoms
Causes
Diagnosis
Treatment and Prognosis
Complications
Prevention
Right atrial enlargement occurs when the right atrium, one of the heart’s upper chambers, is larger than normal. The right atrium is the first entry point of blood returning to theheartfrom circulating in the body. This enlargement can increase the amount of blood and pressure of blood flow leading into the right ventricle and eventually the pulmonary artery in the lungs.
While left atrial enlargement can cause chest pain and breathing problems, alerting you to the dangerous condition, right atrial enlargement usually develops with no symptoms at all.
This article covers the signs and complications of right atrial enlargement. It also discusses the causes, diagnosis, and treatment.
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Types of Right Atrial Enlargement
There are several types ofcardiomegaly,or heart enlargement. Enlargement can affect the entire heart or specific chambers, and you can be born with the condition or develop it from chronic conditions like high blood pressure.
How Big Is Too Big?A normal right atrium can hold between 11 and 40 milliliters (ml) of blood at a time.In people with atrial enlargement, the atrium can hold far more. There have been rare cases in which the right atrium can hold 700 mland even 1,900 ml.
How Big Is Too Big?
A normal right atrium can hold between 11 and 40 milliliters (ml) of blood at a time.In people with atrial enlargement, the atrium can hold far more. There have been rare cases in which the right atrium can hold 700 mland even 1,900 ml.
Right atrial enlargement can also develop over time due to a number of other heart problems or conditions, such as pulmonary hypertension (high blood pressure of the pulmonary arteries) or heart valve disorders.
Symptoms occur more often in people who develop complications from right atrial enlargement or whose condition arose from other cardiac problems. Possible symptoms include:
When Is Discomfort an Emergency?If you have any of the following symptoms—especially if they come on quickly and strongly—call your doctor, 911, or visit an emergency department immediately:Chest pain that continues after rest or medicationShortness of breath, even at restDizzinessCoughing up pink phlegm or bloodLoss of consciousnessUnresponsiveness
When Is Discomfort an Emergency?
If you have any of the following symptoms—especially if they come on quickly and strongly—call your doctor, 911, or visit an emergency department immediately:Chest pain that continues after rest or medicationShortness of breath, even at restDizzinessCoughing up pink phlegm or bloodLoss of consciousnessUnresponsiveness
If you have any of the following symptoms—especially if they come on quickly and strongly—call your doctor, 911, or visit an emergency department immediately:
Some possible causes or conditions related to right atrial enlargement include:
Why Atrial Enlargement Doesn’t Occur AloneWhen atrial enlargement develops over time, it usually indicates severe heart problems. In many cases, there is a domino effect of one problem leading to another. For example, valve disorders like tricuspid regurgitation can cause pressure imbalances, resulting in conditions like pulmonary hypertension. In time, pulmonary hypertension can lead to atrial enlargement or more severe cardiomegaly and heart failure.
Why Atrial Enlargement Doesn’t Occur Alone
When atrial enlargement develops over time, it usually indicates severe heart problems. In many cases, there is a domino effect of one problem leading to another. For example, valve disorders like tricuspid regurgitation can cause pressure imbalances, resulting in conditions like pulmonary hypertension. In time, pulmonary hypertension can lead to atrial enlargement or more severe cardiomegaly and heart failure.
The first step your doctor will take is to complete a physical assessment and ask you about your family and personal medical history. Your doctor will also perform a physical exam and listen to your heart and lungs. You may even have blood work done to check your overall health and wellness.
If these exams or tests raise any red flags, your doctor will move on to heart-specific testing to get more information about how well your heart is functioning. One of the tools your healthcare provider will use is anelectrocardiogram(ECG or EKG). It measures the electrical signals of your heart and how well its electrical and pumping systems are working. However, it’s usually more accurate for diagnosing left atrial enlargement than right atrial enlargement.
An ECG will provide a lot of information to your doctor, but even if a problem is detected on the ECG, there are many things that could be to blame. If your healthcare provider suspects you have right atrial enlargement or is trying to diagnose other heart conditions, a number of tests may be ordered, including:
With some imaging tests, your doctor can see blood flowing in real time through the chambers of your heart. Pressures and sizes can also be measured.
Your doctor may also perform noncardiac tests like an X-ray to rule out other conditions that could be causing problems in the heart, such as respiratory diseases.
Why Atrial Enlargement Develops in AthletesAtrial enlargement can develop in athletes as a result of intense endurance exercises. Heavy exercise can cause cardiac remodeling, which is a group of changes in heart tissue due to the increase in blood volume that occurs during activity. Long periods of increased volume can cause enlargement of the heart—mostly in the left atrium, but it can also happen in the right atrium.
Why Atrial Enlargement Develops in Athletes
Atrial enlargement can develop in athletes as a result of intense endurance exercises. Heavy exercise can cause cardiac remodeling, which is a group of changes in heart tissue due to the increase in blood volume that occurs during activity. Long periods of increased volume can cause enlargement of the heart—mostly in the left atrium, but it can also happen in the right atrium.
Surgery is an option for treatment, but your doctor may also choose to monitor you and treat your symptoms with medications.
A number of serious complications can occur with right atrial enlargement. Since about half of all known cases of right atrial enlargement have no symptoms, the condition can get worse over time without anyone knowing. Eventually, it can lead to more severe problems, such as:
Weak Heart Symptoms and Treatments
Preventing Right Atrial Enlargement
Lifestyle factors may also be helpful for heart and lung health. This includes:
Summary
A Word From VerywellRight atrial enlargement is usually a non-specific condition that develops as a complication of another underlying heart condition or congenital anomaly. If you are diagnosed with right atrial enlargement, make sure to see a cardiologist to help diagnose the root cause of your condition.—CHRISTOPHER LEE, MD, MEDICAL EXPERT BOARD
A Word From Verywell
Right atrial enlargement is usually a non-specific condition that develops as a complication of another underlying heart condition or congenital anomaly. If you are diagnosed with right atrial enlargement, make sure to see a cardiologist to help diagnose the root cause of your condition.—CHRISTOPHER LEE, MD, MEDICAL EXPERT BOARD
Right atrial enlargement is usually a non-specific condition that develops as a complication of another underlying heart condition or congenital anomaly. If you are diagnosed with right atrial enlargement, make sure to see a cardiologist to help diagnose the root cause of your condition.
—CHRISTOPHER LEE, MD, MEDICAL EXPERT BOARD
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Karki DB, Pant S, Yadava SK, Vaidya A, Neupane DK, Joshi S.Measurement of right atrial volume and diameters in healthy Nepalese with normal echocardiogram.Kathmandu Univ Med J (KUMJ). 2014 Apr-Jun;12(46):110-2. doi: 10.3126/kumj.v12i2.13655.Khajali Z, Jorfi F, Parsaee M, Kasaei M, Jafarifesharaki M.Idiopathic Right Atrial Enlargement (Volume: 700 cc) in a Young Man: A Case Report.Int Cardio Res J. 2019 ; 13(4):e92367.Long MA.Giant Right Atrium: An Extreme Case of Idiopathic Dilation of the Right Atrium.Ann of Thorac Surg. 2014;98(5):1815-1818. doi:10.1016/j.athoracsur.2013.12.082.Harrigan RA, Jones K.ABC of clinical electrocardiography. Conditions affecting the right side of the heart.BMJ. 2002;324(7347):1201-1204. doi:10.1136/bmj.324.7347.1201Surace FC, Iezzi F, Colaneri M, Pozzi M.Surgical Treatment of Idiopathic Enlargement of the Right Atrium.Case Reports in Surgery, Vol. 2018. doi:10.1155/2018/7241309.Zhang J, Zhang L, He L, Li H, Li Y, Zhang L, Xie M.Clinical Presentation, Diagnosis, and Management of Idiopathic Enlargement of the Right Atrium: An Analysis Based on Systematic Review of 153 Reported Cases.Cardiology2021;146:88-97. doi:10.1159/000511434Centers for Disease Control and Prevention.Pulmonary atresia.Tsao CW, Josephson ME, Hauser TH, et al.Accuracy of electrocardiographic criteria for atrial enlargement: validation with cardiovascular magnetic resonance.J Cardiovasc Magn Reson. 2008;10(1):7. doi:10.1186/1532-429X-10-7Ko KY, Jang JH, Choi SH, et al.Impact of right atrial enlargement on clinical outcome in patients with atrial fibrillation.Front Cardiovasc Med. 2022;9:989012. doi:10.3389/fcvm.2022.989012American Heart Association.The American Heart Association diet and lifestyle recommendations.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Karki DB, Pant S, Yadava SK, Vaidya A, Neupane DK, Joshi S.Measurement of right atrial volume and diameters in healthy Nepalese with normal echocardiogram.Kathmandu Univ Med J (KUMJ). 2014 Apr-Jun;12(46):110-2. doi: 10.3126/kumj.v12i2.13655.Khajali Z, Jorfi F, Parsaee M, Kasaei M, Jafarifesharaki M.Idiopathic Right Atrial Enlargement (Volume: 700 cc) in a Young Man: A Case Report.Int Cardio Res J. 2019 ; 13(4):e92367.Long MA.Giant Right Atrium: An Extreme Case of Idiopathic Dilation of the Right Atrium.Ann of Thorac Surg. 2014;98(5):1815-1818. doi:10.1016/j.athoracsur.2013.12.082.Harrigan RA, Jones K.ABC of clinical electrocardiography. Conditions affecting the right side of the heart.BMJ. 2002;324(7347):1201-1204. doi:10.1136/bmj.324.7347.1201Surace FC, Iezzi F, Colaneri M, Pozzi M.Surgical Treatment of Idiopathic Enlargement of the Right Atrium.Case Reports in Surgery, Vol. 2018. doi:10.1155/2018/7241309.Zhang J, Zhang L, He L, Li H, Li Y, Zhang L, Xie M.Clinical Presentation, Diagnosis, and Management of Idiopathic Enlargement of the Right Atrium: An Analysis Based on Systematic Review of 153 Reported Cases.Cardiology2021;146:88-97. doi:10.1159/000511434Centers for Disease Control and Prevention.Pulmonary atresia.Tsao CW, Josephson ME, Hauser TH, et al.Accuracy of electrocardiographic criteria for atrial enlargement: validation with cardiovascular magnetic resonance.J Cardiovasc Magn Reson. 2008;10(1):7. doi:10.1186/1532-429X-10-7Ko KY, Jang JH, Choi SH, et al.Impact of right atrial enlargement on clinical outcome in patients with atrial fibrillation.Front Cardiovasc Med. 2022;9:989012. doi:10.3389/fcvm.2022.989012American Heart Association.The American Heart Association diet and lifestyle recommendations.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Karki DB, Pant S, Yadava SK, Vaidya A, Neupane DK, Joshi S.Measurement of right atrial volume and diameters in healthy Nepalese with normal echocardiogram.Kathmandu Univ Med J (KUMJ). 2014 Apr-Jun;12(46):110-2. doi: 10.3126/kumj.v12i2.13655.Khajali Z, Jorfi F, Parsaee M, Kasaei M, Jafarifesharaki M.Idiopathic Right Atrial Enlargement (Volume: 700 cc) in a Young Man: A Case Report.Int Cardio Res J. 2019 ; 13(4):e92367.Long MA.Giant Right Atrium: An Extreme Case of Idiopathic Dilation of the Right Atrium.Ann of Thorac Surg. 2014;98(5):1815-1818. doi:10.1016/j.athoracsur.2013.12.082.Harrigan RA, Jones K.ABC of clinical electrocardiography. Conditions affecting the right side of the heart.BMJ. 2002;324(7347):1201-1204. doi:10.1136/bmj.324.7347.1201Surace FC, Iezzi F, Colaneri M, Pozzi M.Surgical Treatment of Idiopathic Enlargement of the Right Atrium.Case Reports in Surgery, Vol. 2018. doi:10.1155/2018/7241309.Zhang J, Zhang L, He L, Li H, Li Y, Zhang L, Xie M.Clinical Presentation, Diagnosis, and Management of Idiopathic Enlargement of the Right Atrium: An Analysis Based on Systematic Review of 153 Reported Cases.Cardiology2021;146:88-97. doi:10.1159/000511434Centers for Disease Control and Prevention.Pulmonary atresia.Tsao CW, Josephson ME, Hauser TH, et al.Accuracy of electrocardiographic criteria for atrial enlargement: validation with cardiovascular magnetic resonance.J Cardiovasc Magn Reson. 2008;10(1):7. doi:10.1186/1532-429X-10-7Ko KY, Jang JH, Choi SH, et al.Impact of right atrial enlargement on clinical outcome in patients with atrial fibrillation.Front Cardiovasc Med. 2022;9:989012. doi:10.3389/fcvm.2022.989012American Heart Association.The American Heart Association diet and lifestyle recommendations.
Karki DB, Pant S, Yadava SK, Vaidya A, Neupane DK, Joshi S.Measurement of right atrial volume and diameters in healthy Nepalese with normal echocardiogram.Kathmandu Univ Med J (KUMJ). 2014 Apr-Jun;12(46):110-2. doi: 10.3126/kumj.v12i2.13655.
Khajali Z, Jorfi F, Parsaee M, Kasaei M, Jafarifesharaki M.Idiopathic Right Atrial Enlargement (Volume: 700 cc) in a Young Man: A Case Report.Int Cardio Res J. 2019 ; 13(4):e92367.
Long MA.Giant Right Atrium: An Extreme Case of Idiopathic Dilation of the Right Atrium.Ann of Thorac Surg. 2014;98(5):1815-1818. doi:10.1016/j.athoracsur.2013.12.082.
Harrigan RA, Jones K.ABC of clinical electrocardiography. Conditions affecting the right side of the heart.BMJ. 2002;324(7347):1201-1204. doi:10.1136/bmj.324.7347.1201
Surace FC, Iezzi F, Colaneri M, Pozzi M.Surgical Treatment of Idiopathic Enlargement of the Right Atrium.Case Reports in Surgery, Vol. 2018. doi:10.1155/2018/7241309.
Zhang J, Zhang L, He L, Li H, Li Y, Zhang L, Xie M.Clinical Presentation, Diagnosis, and Management of Idiopathic Enlargement of the Right Atrium: An Analysis Based on Systematic Review of 153 Reported Cases.Cardiology2021;146:88-97. doi:10.1159/000511434
Centers for Disease Control and Prevention.Pulmonary atresia.
Tsao CW, Josephson ME, Hauser TH, et al.Accuracy of electrocardiographic criteria for atrial enlargement: validation with cardiovascular magnetic resonance.J Cardiovasc Magn Reson. 2008;10(1):7. doi:10.1186/1532-429X-10-7
Ko KY, Jang JH, Choi SH, et al.Impact of right atrial enlargement on clinical outcome in patients with atrial fibrillation.Front Cardiovasc Med. 2022;9:989012. doi:10.3389/fcvm.2022.989012
American Heart Association.The American Heart Association diet and lifestyle recommendations.
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