Pathology of the heart

Cardiovascular diseases are the most important causes of morbidity and mortality in many 'developed' countries. This contribution gives an overview of the pathological features of the major heart diseases. It details the importance of heart diseases and, where appropriate, their relevance to surgical practice. The incidence of ischaemic heart disease is falling in the UK, but it is rising elsewhere. In developed countries, the falling death rate from myocardial infarction is accompanied by rising incidences of atrial fibrillation and heart failure. Other diseases of the myocardium, such as myocarditis and cardiomyopathy, are considered; the role of viral infections and drugs in the former are emphasized, and the recently recognized role of genetic factors in the latter outlined. The pathogenesis of rheumatic fever is discussed, as is the functional pathology of valve diseases; inflammation of the valves and the pericardium is briefly outlined. The increasingly important entity of congenital heart disease is also mentioned.