Abstract
Hypertrophic cardiomyopathy is histologically characterized by marked hypertrophy and myocardial fiber disarray in the septal region. This finding has been considered important as a diagnostic indicator. In the present study, we examined 127 hearts, especially the interventricular septa, from newborns, children, adults and hypertensives. A local myocardial fiber disarray was detected in all cases at the anterior and the posterior areas of the septum where the left and the right ventricular myocardia meet. The extent varied from case to case. In adults, local disarray was also found in other regions, usually in the left ventricle‐facing longitudinal to the middle layers of the septum. The left ventricle‐facing longitudinal myocardium of the septum in hypertensives showed a hypertrophy change in the sites near the middle layer. The myocardium in this portion was further stratified into several sublayers in some cases. When compared with the findings of hypertrophic cardiomyopathy, septal myocardium of hypertensives still retained a certain degree of regularity in fiber arrangement. Biopsy might be of great value for diagnosing hypertrophic cardiomyopathy, although differentiation from secondary hypertrophic changes due to hypertension or cor pulmonale may be difficult in some cases.
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