Normal and Pathological Anatomy

Abstract

Despite the many possible causes of heart failure, dilatation of the chambers and hypertrophy of the individual myocardial fibres are typically encountered. Exceptions are thesaurismoses (amyloidosis, glycogenoses), which may display thickened heart walls. In the decompensated hypertensive heart, first left ventricular hypertrophy occurs and later dilatation. Due to the increase in diastolic filling pressure and the resulting postcapillary pulmonary hypertension, often right ventricular hypertrophy and later right ventricular dilatation follow. In cor pulmonale, the right ventricle is mostly affected. Macro-scopically, chronic heart failure is characterized by a rounded apex and an increase in transverse diameter, thereby approaching a ball-like shape. The increase in weight is essentially due to the increase in mass, which is promoted by an increased interstitial content of collagen (Hort 1955, 1968).