Studies in Pancreatic Fibrosis

Abstract

1. The cardiac complications of pancreatic fibrosis were studied by clinical examination and autopsy. 2. Of 45 patients with severe pancreatic fibrosis studied clinically, 8 showed cor pulmonale. One of these eight died in right-heart failure, the others showed only electrocardiographic changes characteristic of right ventricular hypertrophy. 3. A comparison of the autopsy findings of 35 patients with pancreatic fibrosis with those of a control series showed no diagnostic differences in cardiac weight or absolute right ventricular thickness. The ratio of right to left ventricular thickness, however, was higher in the group with pancreatic fibrosis, as was the ratio of cardiac weight to body weight. Only 2 out of 35 autopsies showed visceral edema and congestion of significant degree, suggestive of frank right ventricular failure. 4. Physiologic and pathologic considerations are presented concerning the development of pure pulmonary hypertension and its relationship to cor pulmonale, compensated or decompensated. 5. The data presented here suggest that the pulmonary involvement associated with infection is still the principal threat to life in patients with pancreatic fibrosis and the one towards which major therapeutic efforts should be directed.