Cardiac hypertrophy of unknown cause. A study of the Clinical and Pathologic Features in Ten Adults

These cases appear to form a clinical group of which the chief features are: marked cardiac hypertrophy; symptoms of cardiac insufficiency; occurrence of various types of arrhythmia; frequent emboli to the pulmonary and systemic circulations; rapidly progressive course after the onset of symptoms; and death from gradual cardiac failure or in sudden fashion. The cause of the syndrome is unknown. The hearts, at autopsy, all show hypertrophy of the muscle fibers. In some cases, this is the only lesion. In others there is also fibrosis, which, in different instances, may be slight or extensive. There may be areas of necrosis, both old and recent. Intracardiac thrombi are often present. Whether these cases represent a single disase picture, observed at different stages of its development, or are to be regarded as of heterogeneous origin, cannot now be stated. Only a knowledge of the etiology can furnish an answer to this question.