The presence and pathogenesis of endocardial and subendocardial degeneration, mural thrombi, and thromboses of the thebesian veins in cardiac failure from causes other than myocardial infarction

The cardiac pathology of 10 cases of heart disease which were characterized clinically by signs of myocardial insufficiency, and anatomically by ventricular dilatation, is given. Four of the patients had hypertensive heart disease: one, rheumatic heart disease; two, coronary arteriosclerotic heart disease; one, hypertension with coronary arteriosclerotic heart disease; one, a possible toxic myocarditis; and one, possible beriberi heart disease. In all 10 cases there was a hydropic degeneration of the subendocardial myocardium of the dilated ventricle. In nine of the cases there was degeneration of the endocardium. either in the form of endocardial fibrosis or fibrinoid necrosis with or without leucocytic infiltration. In four of these cases there was, in addition to the endocardial and subendocardial degeneration, extensive mural thrombi and thromboses of the thebesian veins. The suggested pathogenesis of the afore-mentioned alterations is intraventricular circulatory stasis, with inadequate oxygenation and nutrition of the portion of tissue normally supplied by blood in the ventricular cavity.