Cardiomegaly pathophysiology: Difference between revisions

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Latest revision as of 01:57, 9 August 2013

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

Cardiomegaly involves two main processes in the heart muscle. Hypertrophy causes the heart to enlarge due to thickening to the cardiac muscle, and dilation causes enlargement due to stretching of the heart muscle. Dilation occurs as a result of volume overload in the heart.

Pathophysiology

The left ventricle can be enlarged from two broad underlying conditions: dilation and hypertrophy.

Left Ventricular Dilation

Left ventricular dilation can occurs as a result of volume overload. Conditions that cause volume overload can be further broken down as follows:

Valvular Disease: More common underlying valvular heart disease conditions would include mitral regurgitation and aortic regurgitation.
Congenital Heart Disease: Patent ductus arteriosus and a ventricular septal defect.
High output states resulting in volume overload: Anemia and thyrotoxicosis.
High stroke volume states: Complete heart block and prolonged severe sinus bradycardia.
Can occur as a result of ischemia and remodeling.

Left Ventricular Hypertrophy

Left ventricular hypertrophy occur due to factors that can cause the heart to work harder than normal. Cardiac hypertrophy is seen in the following condtions:

Pathology

Gross Pathology

Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

Gross excellent example of concentric left ventricular hypertrophy

Left Ventricular Hypertrophy: Gross natural color anterior view intact heart showing disproportionate size of left ventricle by its inferior extent much below the right ventricle apex (quite good example)

Myocardial Infarct: Gross natural color apical section showing large left ventricle infarct and right ventricular hypertrophy

Right ventricular enlargement due to a patent ductus arteriosus in a patient with hyaline membrane disease

References

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@@ Line 1: / Line 1: @@
+__NOTOC__
 {{Template:Cardiomegaly}}
+{{CMG}}; {{AE}} {{CZ}}
-{{CMG}}; '''Associate Editor in Chief:''' {{CZ}}
+==Overview==
+Cardiomegaly involves two main processes in the heart muscle.  Hypertrophy causes the heart to enlarge due to thickening to the cardiac muscle, and dilation causes enlargement due to stretching of the heart muscle.  Dilation occurs as a result of volume overload in the heart.
 ==Pathophysiology==
+The [[left ventricle]] can be enlarged from two broad underlying conditions: dilation and hypertrophy.
+===Left Ventricular Dilation===
+Left ventricular dilation can occurs as a result of volume overload. Conditions that cause volume overload can be further broken down as follows:
+*Valvular Disease: More common underlying [[valvular heart disease]] conditions would include [[mitral regurgitation]] and [[aortic regurgitation]].
+*Congenital Heart Disease: [[Patent ductus arteriosus]] and a [[ventricular septal defect]].
+*High output states resulting in volume overload: [[Anemia]] and [[thyrotoxicosis]].
+*High stroke volume states: [[Complete heart block]] and prolonged severe [[sinus bradycardia]].
+*Can occur as a result of [[ischemia]] and remodeling.
+===Left Ventricular Hypertrophy===
+Left ventricular hypertrophy occur due to factors that can cause the heart to work harder than normal. Cardiac hypertrophy is seen in the following condtions:
+*[[Hypertension]]
+*[[Aortic valve stenosis]]
+*[[Hypertrophic cardiomyopathy]]
+*[[Physical exercise|Atheletic training]]
+==Pathology==
+===Gross Pathology===
+[http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology]
+[[Image:Biventricular Hypertrophy.jpg|left|300px|thumb|Biventricular Hypertrophy]]
+<br clear="left"/>
+[[Image:Biventricular Hypertrophy 1.jpg|left|300px|thumb|Biventricular Hypertrophy]]
+<br clear="left"/>
+[[Image:Left ventricular hypertrophy 2.jpg|left|300px|thumb|Gross excellent example of concentric left ventricular hypertrophy]]
+<br clear="left"/>
+[[Image:Left ventricular hypertrophy 1.jpg|left|300px|thumb|Left Ventricular Hypertrophy: Gross natural color anterior view intact heart showing disproportionate size of left ventricle by its inferior extent much below the right ventricle apex (quite good example)]]
+<br clear="left"/>
+[[Image:Right ventricular hypertrophy.jpg|left|300px|thumb|Myocardial Infarct: Gross natural color apical section showing large left ventricle infarct and right ventricular hypertrophy]]
+<br clear="left"/>
-The [[left ventricle]] can be enlarged from two broad underlying conditions: dilation and hypertrophy.
+[[Image:Right ventricular hypertrophy 1.jpg|left|300px|thumb|Right ventricular hypertrophy]]
+<br clear="left"/>
-*'''Left ventricular dilation:'''
+[[Image: RVE Hyalin membran disease.jpg|left|300px|thumb|Right ventricular enlargement due to a [[patent ductus arteriosus]] in a patient with hyaline membrane disease]]
-:*Can occurs as a result of volume overload. Conditions that cause volume overload can be further broken down as follows:
+<br clear="left"/>
-:*'''Valvular Disease:''' More common underlying [[valvular heart disease]] conditions would include [[mitral regurgitation]] and [[aortic regurgitation]]
-:*'''Congenital Heart Disease:''' [[Patent ductus arteriosus]] and a [[ventricular septal defect]].
-:*'''High output states resulting in volume overload:''' [[Anemia]] and [[thyrotoxicosis]].
-:*'''High stroke volume states:''' [[Complete heart block]] and prolonged severe [[sinus bradycardia]]
-:*Can occur as a result of [[ischemia]] and remodeling
 == References ==
 {{reflist|2}}
-[[Category:Physical examination]]
 [[Category:Cardiology]]
-[[Category:Signs and symptoms]]
+[[Category:Disease]]
-[[Category:Disease state]]
-[[Category:Mature chapter]]
-[[Category:Microchapter candidate]]
 {{WH}}
 {{WS}}