ACROMEGALY AND THE HEART: A CLINICAL AND PATHOLOGIC STUDY

Abstract

Cardiovascular findings in 21 patients with acromegaly were analyzed. Thirteen of the 21 patients presented clinical evidences of heart disease. Five patients were in frank congestive failure, and 2 others had transient episodes of left ventricular failure. Nine of 15 patients with electrocardiographic studies showed abnormal tracings, 6 having impaired intraventricular conduction, and 2 left ventricular hypertrophy. All 4 patients with necropsy studies had cardiac enlargement, in one case to 1140 g. Microscopic sections showed hypertrophy of myocardial fibers, and in 2 cases a conspicuous fibrous tissue proliferation. It is postulated that direct effect of the anterior hormone of the pituitary is the predominant factor causal of the cardiac hypertrophy and fibrous tissue proliferation. However, other contributory factors are the increased work demand by overgrowth of other tissues, and in some instances thyrotoxicosis and impaired glucose metabolism. Hypertension at some time was recorded in 6 patients, and appears to have been poorly tolerated by the acromegalic heart.