RESUMEN
Twenty-three cases of endomyocardial disease (ED) are presented, studied in Venezuela, a tropical country in northern South America. The diagnosis was confirmed in 18 cases by means of pathological studies, and in 5 cases by angiocardiography which showed the characteristic obliterative ventricular lesions. Eosinophilia was present in 35% of the patients. The most frequent clinical feature was heart failure associated with mitral regurgitation. Systemic embolism was the first clinical feature in 5 cases. In 2 cases, ED was associated with autoimmune haemolytic anaemia or vasculitis. Necropsy revealed a predominance of the left-sided (9/16 cases) and biventricular (6/16 cases) types. The pathological lesions were characterised by fibrous thickening of the endocardium at the apex and the ventricular inflow tracts extending to the myocardium and involving the atrioventricular valves. ED is frequently misdiagnosed as rheumatic valvular cardiopathy. The two-dimensional echocardiogram is a very useful procedure for determining the spatial anatomy of ED. The echo findings were closely correlated with ventriculographic and necropsy findings. Even though ED is widely spread around the world, it is most frequently found in tropical and subtropical countries in Africa, Asia and America, such as Venezuela and Brazil. This suggests that there are aetiological factors in these latitudes, about which little is known.
Asunto(s)
Fibrosis Endomiocárdica/diagnóstico , Adolescente , Adulto , Anciano , Angiocardiografía , Ecocardiografía , Fibrosis Endomiocárdica/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , VenezuelaAsunto(s)
Enfermedades Cardiovasculares/epidemiología , Métodos Epidemiológicos , Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Población Rural , Población Urbana , VenezuelaAsunto(s)
Enfermedades Cardiovasculares/epidemiología , Enfermedad de Chagas/epidemiología , Adolescente , Adulto , Enfermedad de Chagas/diagnóstico , Niño , Preescolar , Pruebas de Fijación del Complemento , Electrocardiografía , Métodos Epidemiológicos , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Salud Rural , VenezuelaRESUMEN
The paper reports on a 4-year follow-up study that represents the continuation of a previous cross-sectional study on Chagas' disease carried out in a rural community (Belén) in Venezuela. The earlier study included 1210 persons all over 5 years of age out of a total of 1656 inhabitants and demonstrated a high prevalence of Chagas' infection (47.3%) and a high rate of Chagas' disease seropositivity among those with chronic myocardial heart disease (84.8%); heart disease was found in 17.3% of persons studied. The follow-up study was based on 812 persons and established that in the sample the frequency of Chagas' infection was 16.3% and that of heart disease 2.2%. Clinical, electrocardiographic and radiological analyses were made on patients with previous heart disease as well as on new patients. Different evolutive electrocardiographic patterns have been found, including variations ranging from normal to definitively abnormal.
Asunto(s)
Enfermedad de Chagas/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Enfermedad de Chagas/complicaciones , Niño , Preescolar , Electrocardiografía , Femenino , Estudios de Seguimiento , Cardiopatías/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Población Rural , Factores Sexuales , VenezuelaRESUMEN
It has been estimated that, in vast areas of the American continent, there is a high prevalence of human infection by Trypanosoma cruzi. Such infection can lead to a variety of heart diseases, predominantly with involvement of the myocardium. The aim of the present work was to determine the prevalence of heart disease in two rural areas of Venezuela with a high endemicity of Chagas' disease and to try to determine the natural history of the disease. It is shown that a form of chronic myocardial disease in patients with positive specific serology and good functional capacity is highly prevalent. Electrocardiographic patterns typical of the initial and developing stages of the disease, as well as early abnormalities of the cardiac rhythm, are described and illustrated. The present work forms part of a longitudinal study still in progress.
Asunto(s)
Enfermedad de Chagas/complicaciones , Cardiopatías/etiología , Adolescente , Adulto , Anciano , Niño , Preescolar , Electrocardiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , VenezuelaRESUMEN
The four-year follow-up study reported herein represents the continuation of a previous cross-sectional study carried out in a rural community (Belen, Venezuela). The earlier study included 1,210 persons out of a total of 1,656 inhabitants, all over five years of age, and demonstrated a high prevalence of Chagas' infection (47.3 per cent) and a high rate of Chagas' disease seropositivity among those with chronic myocardial heart disease (84.8 per cent); heart disease was found in 17.3 per cent of persons studied. It included clinical, electrocardiographic and radiological analyses
The present report describes the results of the four-year follow-up study performed in 812 persons, which permitted to establish the incidence of Chagas' infection (16.3 per cent) and that of chagasic heart disease (2.2 per cent) in four years. The report also included the clinical, electrocardiographic and radiological analyses of cases with previous heart disease as well as new cases. Different evolutive electrocardiographic patterns have been found, including serial electrocardiographic variations ranging from normal to definitely abnormal. The mortality occurred in the sample during the observation period is reported(AU)
Publicado en inglés en el Bull. WHO 39:341-348, 1968