| Dilatation
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Etiology
•Case of 19 yr. female with SLE, chronic renal
failure with hypertension, and dying of an ensuing
acute hemorrhagic pancreatitis. The heart weighed 600g
due to hypertension, and was dilated.
•Causes of dilatation are heart failure, chronic
anemia, thiamine deficiency (beri beri heart disease),
myocarditis, toxemias of diverse causes associated
with shock.
•Causes in this case are anemia coupled with a
hypertrophied heart subject to failure with sufficient
stress, such as the toxemia and shock of acute
hemorrhagic pancreatitis.
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Pathogenesis
•Specifics are unknown.
•It is likely that any disease state that results in
universal injury to the myocardium, such as anemia, is
going to result in less effective fiber contraction,
with incremental decreases in ejection fraction causing
incremntal compensatory increases in fiber length,
until an adequate ejection fraction is restored.
•In this case, cardiac hypertrophy with relative
coronary insufficiency, anemia, and the shock and
toxemia of pancreatitis (metabolic acidosis and a
"cytokine storm") are all contributory.,
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Epidemiology
• Varies with diverse causes.
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General Gross Description
•The chambers are dilated, with relative thinning
of the walls, and characteristic flattening or
"ironing out" of the trabeculae carnae in the
ventricles.
•The myocardium in cases of severe chronic anemia
such as untreated pernicious anemia, classically showed
fatty deposits within myocardial fibers appearing
grossly as yellow stripe-like discolorations described
as "tigering" because of the resemblance to tigers.
•Examples:
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General Microscopic Description
•Elongation of muscle fibers has no distinguishing
histologic features. Dilatation is a gross feature.
•Examples:
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Clinical Correlation
•An indicator of cardiac failure
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References
•None
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| Dilatation
| | Synopsis by: J. Hasson, MD (T32000M32100)[343]
| |