In the setting of pulmonary hypertension, what structural change occurs in the right ventricle?

In the context of pulmonary hypertension, the right ventricle undergoes hypertrophy as it faces increased afterload due to elevated pressures in the pulmonary circulation. This condition forces the right ventricle to work harder to pump blood into the pulmonary arteries. The sustained pressure overload results in the thickening of the myocardial wall, commonly referred to as hypertrophy.

As the right ventricle undergoes hypertrophy, its chambers may also adapt over time; however, the primary and earliest response to sustained pressure overload is the increase in muscle mass, which is a compensatory mechanism aimed at maintaining cardiac output despite the increased workload. This structural adaptation may eventually lead to dilation as the disease progresses, but the initial change in response to pulmonary hypertension is hypertrophy. Therefore, recognizing this key adaptive response is essential for understanding the pathophysiology of heart changes in pulmonary hypertension.