In response to an increased workload due to physiological or pathological stimuli, the heart may undergo a process of
growth with increased muscle mass called cardiac hypertrophy. It is a particular mechanism of long term compensation
used by the heart to adapt permanently to a greater workload.
Although, through its peculiar structural, molecular and metabolic characteristics, in early stage the hypertrophy allows to
maintain an adequate cardiac function, after a variable period of time, the same characteristics promote the evolution to
contractile dysfunction and heart failure. The latter represents an important cause of death and so the cardiac hypertrophy
increases the cardiovascular morbidity and mortality.
In this paper we report a rare case of extremely high degree of concentric cardiac hypertrophy, with a heart weight of 1050
g and longitudinal diameter of 16.5 cm, transverse diameter of 16 cm and antero-posterior diameter of 9 cm. The thickness
of the left ventricle free wall was 4.2 cm, of the septum 4.3 cm and at the apex level 3.5 cm.
These data, compared with those described in scientific literature, indicate the exceptional nature of our necropsy finding
of a huge cardiac hypertrophy.
The analysis of the pathogenetic mechanisms, which may determinate the fatal event in case of cardiac hypertrophy, shows
that in the described case the death cause can be the onset of heart failure in presence of cardiomegaly
