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(Chest. 1960;38:435-446.)
© 1960 American College of Chest Physicians

Bilateral Ventricular Hypertrophy Due to Chronic Pulmonary Disease

NICHOLAS MICHELSON M.D., F.C.C.P.1

1 The Department of Medicine and Surgery, Veterans Administration Hospital, Castle Point, New York and Lyons, New Jersey.

A series of 32 necropsy cases with bilateral ventricular hypertrophy due to chronic, severe pulmonary diseases is analyzed.

Three individuals had bilateral atrial hypertrophy, and three right atrial hypertrophy only.

The thickness of the right ventricular wall ranged from 3 to 5 millimeters in the mildest case of cor pulmonale and from 10 to 15 millimeters in the severest case.

The thickness of the left ventricular wall ranged from 10 to 15 millimeters in the mildest case of cor pulmonale and also from 10 to 15 millimeters in the severest case. However, in several intermediate cases the left ventricular wall measured from 10 to 20 millimeters in thickness.

An arrangement of the cases according to increasing thickness of the right ventricular wall did not disclose a parallel quantitative progression in the left ventricular hypertrophy. This is substantiated by ratios as well as by the percentage increases above normal values, computed for the maximal widths of both ventricles.

For the whole series the hypertrophy was much greater in the right than the left ventricle. For the thickness of the right ventricular wall the percentage increase above normal amounted to 400 per cent in the severest case. For the left ventricle the maximum percentage increase above normal amounted to 66 per cent. However, with the exception of one single case, the absolute thickness of the right ventricular wall was considerably less than the absolute thickness of the left ventricular wall.

The right ventricular hypertrophy was reflected In the electrocardiogram by right axis deviation.

Seven cases with a hypertrophied christa supraventricularis did not show an rsR' pattern in leads V1, or V2. Such a pattern with a delayed onset of the intrinsicoid deflection could be demonstrated for a contrast case without right ventricular hypertrophy but with left ventricular hypertrophy.






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Copyright © 1960 by the American College of Chest Physicians.