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Like any other muscular tissue, the heart hypertrophies when it has more work to do, provided this work is gradually increased and the heart is not strained by sudden exertion. To hypertrophy properly the heart must go into training. This training is necessary in valvular lesions after acute endocarditis or myocarditis, and is the reason that the return to work must be so carefully graduated.
This causes passive congestion of the lungs, and the right ventricle finds that it must labor to overcome the increased resistance in the pulmonary artery, and hypertrophies to overcome this increased amount of work. When this condition has become perfected, compensation is established and the circulation is apparently normal.
Endocarditis Acute, simple malignant Chronic Valvular Lesions Broken compensation Cardiac drugs Diet Resort treatment Cardiac disease in children Cardiac disease in pregnancy Coronary sclerosis Angina pectoris Pseudo-angina Stokes-Adams disease Arterial hypertension Cardiovascular-renal disease Arrhythmia Auricular fibrillation Bradycardia Paroxysmal tachycardia Hyperthyroidism Toxic disturbances Physiologic hypertrophies Simple dilatation Shock Stomach dilatation Anesthesia in heart disease
Mentally he was dull; the bones of the face and extremities showed the hypertrophies characteristic of acromegaly, the soft parts not being involved. The circumference of the trunk at the nipples was 62 inches, and over the most prominent portion of the kyphosis and pigeon-breast, 74 inches.
The left auricle finds it difficult to empty all of its blood into the left ventricle during the ordinary diastole of the heart. This auricle then somewhat hypertrophies, but is unable to prevent more or less damming back of the blood into the lungs through the pulmonary veins.
Among the benign bone tumors are exostoses homologous outgrowths differing from hypertrophies, as they only involve a limited part of the circumference. Barwell had a case of a girl with 38 exostoses. Erichsen mentions a young man of twenty-one with 15 groups of symmetric exostoses in various portions of the body; they were spongy or cancellous in nature.
The previous history of such a patient will generally disclose the pathologic cause or the physical excuse. As soon as a valve has become injured the heart muscle hypertrophies to force the blood through a narrowed orifice or to evacuate the blood coming into a compartment of the heart from two directions instead of one, as occurs in regurgitation or insufficiency of a valve.
Fibrous tissue or cartilage may form in one or more of the fatty fringes and give rise to hard nodular masses, which may attain a considerable size, and in course of time may undergo ossification. Like other hypertrophies on a free surface, they tend to become pedunculated, and so acquire a limited range of movement. The pedicle may give way and the body become free.
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