Massive cardiac hypertrophy: Report of 15 hearts weighing 1,000 Gm. or more

Abstract

A series of 15 hearts weighing 1,000 gm. or more is reported. Fourteen of these were encountered among 11,595 consecutive necropsies (1 in 828). The principal associated lesions were hypertension and arteriolar nephrosclerosis, syphilitic aortic insufficiency and severe rheumatic mitral and aortic valvulitis. Individual instances of acromegaly with hypertension, severe coronary arteriosclerosis and chronic mediastinopericarditis were encountered. Extreme cardiac hypertrophy (1,000 gm. or more) is found almost exclusively among men (about 95%), and all 15 of our patients were men. A number of factors acting in combination appeared to be of etiologic importance in the production of extreme degrees of cardiac hypertrophy in our patients. These included sex, chronic hypertension, arteriolar nephrosclerosis or glomerulonephritis, severe valvular disease and long periods of cardiac decompensation. In the patient with acromegaly, an additional factor was hypersecretion of growth hormones.