Pathogenesis of Pulmonary Heart Disease in Pulmonary Tuberculosis

Abstract

Out of 583 autopsied cases in Yokufukai (Old people's home) during the last 6 years, pulmonary tuberculosis was found in 59 cases. Clinico-patho-logical study was carried out to clarify the factors responsible for the disturbances in pulmonary circulation and right heart enlargement in these cases. 1. The incidence of pulmonary atherosclerosis and of right heart enlargement in the cases with pulmonary tuberculosis complicated by pulmonary emphysema was higher than that in the cases with pulmonary tuberculosis alone. 2. In the cases with pulmonary tuberculosis alone, the incidence of pulmonary atherosclerosis was increased with the extent of tuberculous foci, and that of the right heart enlargement was the highest in far advanced group. As the clinical course was prolonged, moreover, the incidence of right heart enlargement was further increased in far advanced cases. 3. In the post-mortem study, obliteration and narrowing of the pulmonary arteries due to the intimai fibrosis with infiltration of round cells and the increase in elastic fibers in the media were found in the tuberculous foci or in the neighboring area. 4. These results suggested that the anatomical factor played an important role in the development of pulmonary heart disease in pulmonary tuberculosis. © 1965, The Japan Geriatrics Society. All rights reserved.