Right Ventricular Hypertrophy

Clinical History

This 56 year old female suffered from emphysema and gave a 2-year history of increasing shortness of breath on exertion associated with recurrent attacks of bronchitis. On examination, BP 160/90 mm Hg, pulse 96, 6 cm of jugular venous congestion. The apex beat was impalpable, bilateral crepitations were heard and pitting oedema was present peripherally. Special investigations: ECG showed right heart strain pattern. Arterial blood examination showed respiratory acidosis. Despite treatment there was steady deterioration and death.

Pathology

The specimen is of the external surface of the heart viewed from the anterior aspect. The right ventricle is greatly enlarged and hypertrophied. All appears to be normal otherwise. This is an example of right ventricular hypertrophy in a patient with emphysema.