Cardiomegaly pathophysiology

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

Pathophysiology

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

• 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.

Pathology

Gross Pathology

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

Biventricular Hypertrophy

Biventricular Hypertrophy

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 hypertrophy

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