Other less common causes of right ventricular hypertrophy are high altitude, left to right shunt, an atrial septal defect, a ventricular septal defect, anomalous pulmonary venous return, Eisenmenger syndrome, stenosis of the pulmonic valve or pulmonary artery, hyperthyroidism, cardiac fibrosis and cardiomyopathy affecting RV, and athlete heart syndrome cialis 20mg for sale PRL secretion is stimulated by suckling, thyrotropin releasing hormone TRH, estrogen, and vasoactive intestinal polypeptide Fig