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An autopsy case of hypertrophic cardiomyopathy with pathological findings suggesting chronic myocarditis

H Kawano1, S Kawai, T Nishijo

  • 1Research Laboratory for Cardiovascular Pathology, Juntendo University School of Medicine, Tokyo, Japan.

Japanese Heart Journal
|January 1, 1994
PubMed

Insights

This case study highlights myocardial fibrosis in hypertrophic cardiomyopathy (HCM). An undefined inflammatory process may contribute to fibrosis, beyond coronary artery issues.

Area of Science:

  • Cardiology
  • Pathology

Background:

  • Hypertrophic cardiomyopathy (HCM) is a condition where the heart muscle thickens.
  • Myocardial fibrosis, the scarring of heart tissue, is implicated in HCM's impact on left ventricular function and dimensions.

Observation:

  • A 68-year-old woman with HCM underwent surgery for interventricular septum myectomy.
  • The resected tissue showed significant round cell infiltration, myocardial fibrosis, and disarray.
  • The patient later experienced congestive heart failure and died of renal failure.

Findings:

  • Autopsy revealed extensive myocardial fibrosis and significant lymphocyte infiltration in the ventricular myocardium.
  • The CD4 to CD8 lymphocyte ratio was 3.8, differing from typical viral myocarditis.
  • This suggests an inflammatory process contributing to fibrosis in HCM.

Implications:

  • The findings suggest an undefined inflammatory process may cause fibrosis in HCM.
  • This is in addition to potential ischemia from small coronary artery stenosis.
  • Further research into inflammatory pathways in HCM is warranted.

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