Asymmetric septal hypertrophy in autopsies in men

Asymmetric septal hypertrophy (ASH) was not identified in the 2,790 autopsies performed in a Veterans Administration hospital since 1958. Recent reports consider ASH to be a common cardiac disease in the diffuse form that has extensive myofiber disorientation. A retrospective study of 419 autopsies was undertaken to see if that diagnosis had been overlooked; but, in 100 autopsies with detailed photographic records of ventricular and septal size, ASH was not found. There were slight average increases in the posterior portions of the septum and right ventricle, and an average septal-left ventricular ratio of 1.1. Since neither staff pathologists nor consultants who reviewed entire hearts with cardiomyopathy noted features of ASH, we consider it to be a rare disease in elderly veterans.