With an underlying arrhythmogenic syndrome, because LVH exacerbates electric Part of the spectrum of HCM 2) a trigger for fatal arrhythmias in individuals Postulated theories include that it is 1) The significance of idiopathic LVH and its causal Hypertension or valvular conditions, as these conditions increase the afterload Weight according to established nomograms.Ģ) Absence of the pathognomonic histological featureģ) Absence of a past medical history of arterial Professor Sheppard, one of our senior investigators, was among theįirst cardiac pathologists to describe idiopathic LVH and distinguish it from hypertrophicĬardiomyopathy (HCM) with specific pathologic criteria.ġ) Unexplained LVH (heart weight > 500 g in malesĪnd > 400 g in females or increased heart weight as a function of body Selective cohorts idiopathic LVH may be reported in up to 30% of sudden cardiacĭeaths. Studies from our group and others reveal that in Distinguish? Appreciate that nuclei of normal uterus are very close together, indicative of narrow cell shape, whereas there's a marked increase in distance between nuclei of hypertrophied smooth muscle cells.Idiopathic left ventricular hypertrophy (LVH) is aįairly novel entity that is increasingly reported following post-mortemĮxamination in cases of sudden cardiac death (SCD) 9,10. The hypertrophied smooth muscle cells of the gravid uterus are large with recognizable cell outline and plump elongated nucleus with a nucleolus as indicated by red arrows. Microscopically, normal uterine smooth muscle cells have an ill-defined border, but have long spindle-shaped nucleus with very small nucleolus. During the first trimester, it becomes a grapefruit, during the 2nd trimester a papaya and then a watermelon by the 3rd trimester. Using fruit as a reference point, a normal uterus is about the size of a pear or an avocado. Compare the size of the normal uterus to that of a gravid uterus in the left image. Gravid uterus This is a case of physiologic hypertrophy and hyperplasia of smooth muscles in the wall of the uterus in response to trophic factor estrogen associated with pregnancy. Can see these concepts at work! Can't proliferate: hypertrophy and atrophy Can proliferate: hypertrophy/hyperplasia and atrophy/apoptosis The overweight man demonstrates atrophy of his skeletal muscle due to decreased functional demand as well as hypertrophy of adipose tissue due to trophic factor stimulation. There's also concurrent atrophy of the adipose tissue (little body fat). Body builder: skeletal muscle hypertrophy is associated with a physiologic increase in functional demand resulting from increased resistance (weight lifting) and is physiologic in nature. 2 pictures example: same person before and after training! Both hypertrophy and atrophy are seen. Adaptive cellular changes are often reversible when the chronic stress of physiologic stimuli are removed. Cells capable of proliferating will respond to the addition of trophic factors by hyperplasia and hypertrophy, or when trophic factors are withdrawn they'll respond by apoptosis and atrophy. Similarly, cells that are not capable of proliferating (skeletal and myocardial myocytes), undergo atrophy without apoptosis however, apoptosis often accompanies atrophy of cells that are capable of proliferating. Cells that are not capable of proliferating, such as skeletal and myocardial myocytes, undergo hypertrophy without proliferation however, hyperplasia often accompanies hypertrophy of cells capable of proliferating.

Pathological hypertrophy definition