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Topic

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Right ventricle

The right ventricle (RV) is one of the four chambers of the heart, forming the majority of the anterior (sternocostal) surface and part of the inferior surface. It receives venous blood from the right atrium through the tricuspid valve and pumps it into the pulmonary trunk via the pulmonary valve, directing blood toward the lungs for oxygenation.

The RV has a crescentic shape in cross-section, with thinner walls (3–5 mm) than the left ventricle, reflecting its lower-pressure pulmonary circulation. Internally, it contains trabeculae carneae, the moderator band (septomarginal trabecula), and papillary muscles attached to tricuspid valve leaflets by chordae tendineae.

Synonyms

  • RV

  • Right heart ventricle

  • Right cardiac chamber

Function

  • Receives deoxygenated blood from the right atrium

  • Pumps blood into the pulmonary circulation for gas exchange

  • Maintains low-pressure, high-volume output suitable for the pulmonary vascular bed

  • Works in coordination with the left ventricle for balanced cardiac output

Arterial Supply

  • Supplied mainly by the right coronary artery (RCA), including:

    • Right marginal branch (supplying the RV free wall)

    • Acute marginal branches

  • Additional supply from the left anterior descending artery (LAD), especially the anterior wall near the interventricular septum

Venous Drainage

  • Blood drains via the small cardiac vein and anterior cardiac veins directly into the right atrium

  • Part of the coronary sinus system

Nerve Supply

  • Sympathetic fibers: from the cardiac plexus, derived from thoracic sympathetic ganglia → increase contractility and heart rate

  • Parasympathetic fibers: from the vagus nerve (CN X) → decrease contractility and heart rate

  • Afferent fibers: carry sensory signals for cardiac reflexes and pain

MRI Appearance

T1-weighted images:

  • RV myocardium appears as intermediate signal intensity

  • Intraventricular blood pool is low signal (flow void)

  • Wall thickness and morphology can be assessed

T2-weighted images:

  • RV myocardium is intermediate to low signal

  • Intraventricular blood appears variable (often hyperintense due to slow flow)

  • Myocardial edema or inflammation appears hyperintense, useful in myocarditis or infarction

STIR (Short Tau Inversion Recovery):

  • Suppresses fat, highlighting myocardial edema, infiltration, or acute inflammation

  • Normal myocardium = low signal, pathology = bright hyperintensity

T1 Post-Contrast (Gadolinium-enhanced):

  • Pathology: late gadolinium enhancement (LGE) identifies myocardial infarction, fibrosis, or scarring

  • Contrast helps assess RV wall motion, perfusion, and cardiomyopathies

CT Appearance

Non-contrast CT:

  • Myocardium is soft tissue density; wall thickness can be assessed

  • Useful for identifying chamber size and calcifications

Contrast-enhanced CT (Cardiac CT / CTA):

  • Blood pool enhances brightly with contrast

  • RV myocardium and trabeculae clearly visualized

  • Excellent for assessing RV morphology, congenital anomalies, pulmonary hypertension, and cardiac masses

  • CTA delineates coronary artery supply to the RV

MRI images

Right ventricle MRI coronal image -img-00000-00000

CT image

Right ventricle anatomy CT axial image -img-00000-00000