Heart weight of Jamaicans. Autopsy study of normal cases and cases of hypertension and chronic lung disease.

AN ENLARGED HEART is one of the more important signs of heart disease and may be present without clinical symptoms or other physical abnormalities. Both clinical and radiological examination are relatively crude methods of detecting the less severe forms of cardiac enlargement, particularly of the right ventricle. The pathologist is in the best position to assess heart size because he is able to weigh and measure various parts of the heart at autopsy. Most autopsies are not performed on normal persons. The nearest approach to normality may be obtained by considering autopsy material selected from traumatic deaths, but even with these there may be some unknown disease process present. For practical purposes normal cases have to be taken from the general autopsy population. By excluding those cases in which disease processes are known to produce an increase in heart weight, it is possible to acquire data on the normal range of heart weight, but the values obtained have limitations by virtue of selection.1 In these circumstances it is not surprising that there is considerable variation of opinion about the range of normal heart weight. Generally pathologists rely on "normal" values obtained from European and North American studies,2 5 which usually relate body weight and height to heart size. It has recently been shown that the heart weights of Uganda Africans were less than those in European and North American studies. The smaller heart weight appeared to be directly related to the smaller body size in