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Published on: January 4, 2013
Cerebral infarction in autopsies of chagasic patients with heart failure
Roque Aras1, José Alberto M da Matta, Gildo Mota
1Universidade Federal da Bahia, Salvador, BA, Brazil. raras@ufba.br
Insights
Encephalic infarction is a frequent finding in Chagas
Area of Science:
- Neurology
- Cardiology
- Pathology
Background:
- Chagas' disease is a significant cause of heart failure.
- Neurological complications of Chagas' disease are not fully understood.
Purpose of the Study:
- To determine the frequency of encephalic infarction in Chagas' disease patients with heart failure.
- To assess the contribution of encephalic infarction to mortality in this population.
Main Methods:
- Retrospective analysis of medical records and autopsy reports.
- Study included patients with Chagas' disease and heart failure over 45 years.
- Data collected on clinical history, examinations, and cause of death.
Main Results:
- Encephalic infarction occurred in 17.5% of Chagas' disease heart failure patients (92/524).
- Brain infarction was most common (15.8%), followed by cerebellum (1.5%) and hypophysis (0.4%).
- Cerebral infarction and its complications were associated with death in 52% of cases.
Conclusions:
- Cerebral infarction is a frequent autopsy finding in Chagas' disease patients with heart failure.
- It represents an important cause of death in endemic regions.
- Complications of cerebral infarction significantly contribute to mortality.
Objective:
To determine the frequency of encephalic infarction and its contribution to lethality in patients with Chagas' disease and heart failure.
Methods:
Medical records and autopsy reports of patients with Chagas' disease complicated by heart failure, who died at the Professor Edgar Santos Hospital of the Federal University of Bahia in the past 45 years were retrospectively analyzed. Data comprised information regarding the clinical history on hospital admission, complementary and anatomicopathological examinations, including the presence of encephalic infarction, the impaired region, and the cause of death.
Results:
Of the 5,447 autopsies performed, 524 were in patients with heart failure due to Chagas' disease. The mean age was 45.7 years, and 51 (63%) patients were of the male sex. The frequency of encephalic infarction was 17.5%, corresponding to 92 events in 92 individuals, 82 (15.8%) of which involved the brain, 8 (1.5%) involved the cerebellum, and 2 (0.4%) involved the hypophysis.
Conclusion:
Cerebral infarction has been a frequent finding in autopsies of chagasic patients with heart failure, and it has been an important cause of death in our region. The presence of cerebral infarction and its complications have been associated with death in 52% of the cases studied.
