Key result
Idiopathic cardiomegaly in elderly men features myocardial hypertrophy, focal fibrosis, and posterior LV endocardial fibroelastosis.
Why the study?
Idiopathic cardiomegaly in the aged with unknown etiology leading to refractory heart failure and its morphological and conduction system characteristics were not well described.
Case Report (n=3)
No
This case series describes the pathological features of idiopathic cardiomegaly in the elderly, highlighting specific myocardial and conduction system degeneration.
Idiopathic cardiomegaly with focal fibrosis merits consideration in refractory HF; leaves open distinct etiologic pathways in the aged.
Three cases of idiopathic cardiomegaly in the aged (64, 82 and 73 years old) were presented. All of them were male and had the common finding of cardiac enlargement of unknown etiology, terminating in refractory heart failure. They showed hypertrophy and degeneration of the myocardium with a peculiar accumulation of focal myocardial fibrosis and endocardial fibroelastosis in the posterior wall of the left ventricle. Overdosage of norepinephrine (Case 1), positive serologic test for syphilis (Case 2) and associated mitral insufficiency (Case 3) might give some modifications to the original myocardial disease. A study of the conduction system revealed degenerative changes similar to the myocardium, which caused the left bundle branch block in Case 2.
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Ohkawa et al. (1971) conducted a case report in Idiopathic cardiomegaly (n=3). Idiopathic cardiomegaly was evaluated on Morphological and clinical characteristics. Three elderly men with idiopathic cardiomegaly exhibited myocardial hypertrophy and degeneration with peculiar focal fibrosis and endocardial fibroelastosis in the posterior left ventricular wall.
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