This critical study of atrophy of the heart is based upon a detailed analysis of 85 proved cases. The clinical, roentgenographic and electrocardiographic features are considered to be sufficiently distinctive to facilitate antemortem recognition. The clinical implications of atrophy of the heart and the reversibility of atrophy and hypertrophy are emphasized.ATROPHY of the heart is defined as an acquired reduction in the size and mass of this organ. While hypertrophy has been the subject of considerable study and investigation, the entity of atrophy has been in the main overlooked and neglected. Rarely do modern textbooks on cardiology mention it, and then only to dismiss it with a few lines pointing to its rarity and lack of clinical significance. However, recent reports on the effects of prolonged bed rest23-34 and starvation35-44 on the cardiovascular system have focused attention on the reversible changes occurring in the hearts of such patients which appear to be comparable to those occurring in cardiac atrophy. For this reason it was thought advisable to study atrophy of the heart, placing particular emphasis on the following aspects: (1) incidence, (2) etiologic factors, (3) gross and microscopic pathologic features, (4) clinical, radiologic and electrocardiographic picture, and (5) cardiovascular functional status.MATERIAL AND METHODSThe protocols of 2,000 consecutive autopsies performed in the Institute of Pathology, Western Reserve University, between March 31, 1941, and October 21, 1946, were reviewed. The 85 cases in which the diagnosis of atrophy of the heart had been made were selected for further study and analysis. The clinical histories, electrocardiographic tracings, x-ray films of the chest and pathologic sections of the heart were re-examined and analysed in detail. These observations, and their correlation, together with a survey of the literature available on the subject, form the material for this report.

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