CASE HISTORY

The patient was a typical case of acromegaly of four years duration. On the day of admission she suddenly passed into coma. On admission she was deeply comatose but with no definite nervous sign other than a bilateral extensor plantar response. Heart enlarged. B.P. 230/140. Vessels thickened. Eyes showed bilateral papilloedema with thick vessels and retinal haemorrhage. Patient died with 24 hours of admission.

PATHOLOGY

Heart 210mmx230mmx155mm. The left ventricle has been opened from the front and shows an enormous degree of muscular hypertrophy, the ventricular wall being at least twice normal thickness. The muscle is firm and appears quite healthy. The left coronary artery has been cut across and appears healthy apart from one minute plaque of atheroma at the beginning of the recurrent branch. The right ventricle (visible at the side of the specimen) is also hypertrophied though to a lesser extent.