The autopsy examination revealed a morbidly obese woman with extensive fibrous adhesions of the pericardium to the anterior chest and severe right ventricular dilatation and ventricular hypertrophy. The left ventricle was normal. The enlarged liver showed passive congestion characterized by diffuse nutmeg parenchyma. The parenchyma of both lungs was brown, firm to rubbery, and similar to the texture of skeletal muscle. Both kidneys showed slightly thin atrophic cortex ranging from 0.5 to 0.7 cm. The neuropathology examination revealed normal brain (1300gm) and spinal cord.