HYPERTROPHY OF THE HEART IN INFANTS

The literature dealing with cardiac hypertrophy in infancy has increased year by year since the early papers of Simmonds 1 and Oberndorfer, 2 which appeared in 1899 and 1906, respectively. No longer may the term "congenital idiopathic hypertrophy" be applied to every enlarged heart in infancy—excluding, of course, those showing gross morphologic anomalies in development. A careful study of individual cases has shown a varied etiology, including coarctation of the aorta, renal insufficiency, primary or essential hypertension, disturbed carbohydrate metabolism accompanied with the storage of excess glycogen in the fibers of the muscle and diffuse myocardial fibrosis secondary to myocardial injury. In a comparatively small number of cases, however, the use of the term "congenital idiopathic hypertrophy" is still warranted, for they present a definite clinical and pathologic entity, the source of which still remains obscure. Abbott 3 described this entity as being "characterized by great cardiac enlargement in the