Significance of right ventricular hypertrophy in a child

My 7-year-old son had an EKG one year ago to check for rheumatic fever (as a cause for a chronic movement disorder).  EKG showed possible RVH, with suggestion to repeat EKG in one year.  Repeat EKG showed RVH.  Not much info available on RVH.  It seems to be a symptom of a larger problem, such as pulmonary stenosis, pulmonary hypertension, or tetralogy of Fallot (isn't this always diagnosed as an infant, and wouldn't I see other signs if this was the case?).  I understand RVH is very rare.  He is scheduled for an echo and chest x-ray.  If RVH is confirmed, what other tests will be required to determine the cause?  I am unable to find a treatment anywhere.  Is there one?  Will he have any restrictions placed on him?  What are the long and short-term implications of this?  Although we have significant heart disease in my family (always past age 60), we have no family history of pediatric cardiac problems.  Thank you so much for taking the time to answer my questions!

[Cleveland Clinic]

fisher,

Dont put the horse before the cart.

The ecg is an electrical picture of the heart. The pediatric ecg has some differences from an adult ecg. One of these differences can represent changes consistant with RVH in an older pediatric patient and be normal in a younger patient. Typically the change in ecg takes place between ages 3-8. This is most likely why it was recommended to check again in a year.

RVH comes from overload on the chamber of the heart. An echocardiogram is an actual picture of the heart and more accurate for detecting structural changes. This most likely would be the next step.

Don't worry about treatment and outcomes before you find out if this is just a normal variant.  I'm not a pediatrician or a pediatric cardiologist, my next step would be to see and discuss testing with either of those if he were my child.

hope this helps.