MYXEDEMA HEART: A PATHOLOGICAL AND THERAPEUTIC STUDY

Abstract

A pathological study of a patient dying of congestive heart failure consequent to myxedema showed that the heart was diffusely dilated and globular. Microscopic exam. of the heart muscle revealed hydropic vacuolization, loss of striation, branching, pyknotic nuclei and irregularity in the staining properties of the muscle fibrils. Strikingly similar path. findings are reported in beriberi heart disease and are occasionally seen in hearts of patients dying other than cardiac deaths, but the Ecg picture is not the same in these instances, being characteristic only in myxedema. Either identical path. processes fail to produce typical Ecg patterns or the metabolic disturbance is primarily responsible for the Ecg in myxedema. A second patient with myxedema heart disease was given large doses of thiamin and vit. B complex but failed to show any change in Ecg, decrease in heart size, lowering of the BMR or decrease in the blood cholesterol levels. This patient responded promptly to thyroid medication. Thus thiamin and vit. B complex appear to be ineffective therapeutic agents for treating myxedema heart.