Diagnosis: Congestive Heart Failure
• Chronic congestive heart failure is a massive public health burden in the United States. The prevalence has increased dramatically in recent years because of an aging population and better outcomes for acute coronary events.
• The relationship of primary pulmonary hypertension and the heart is well understood and involves dilation of the right side of the heart (cor pulmonale).
• Pathologic changes in the lungs are commonly seen at autopsy in patients with left-sided heart failure but are perhaps less commonly discussed outside of the autopsy setting.
• The pathologic changes in the lung include:
• Intimal thickening of the arteries and veins
• Muscularization of the arterioles and venules
• Fibrosis of veins and arteries
• Thickening of alveolar walls with type 2 pneumocyte hyperplasia
• Bronchial smooth muscle hypertrophy
• Increased capillary basement membrane thickness
