[Thromboembolism in patients with apical lesion caused by chronic chagasic cardiopathy]

The thromboembolism in patients with apical lesion of the chronic Chagas' heart disease diagnosticated by left cineventriculography are present in this study. The series comprises 32 females and 23 males between the ages of 22 and 69 years, all presenting cardiovascular symptoms, 20 in cardiac failure (10 with left ventricular failure and 10 in congestive heart failure). Heart size was normal in 35 instances and 20 showed cardiomegaly on chest X-ray examinations (slight in 8, moderate in 6 and marked in 6). The following morphological aspects of the apical lesions were observed: mammillary-23 (41.82%); digital-18 (32.73%) and semilunar-14 (25.45%). In 8 cases (14.54%) intraventricular thrombi were detected and 10 these were associated with discinetic areas. Seventeen episodes of thromboembolism occurred in 14 (24.45%) patients including 7 to the brain, 9 to the lung and 1 to the iliac right artery, mostly in patients with heart failure. Eight were women and 6 were men, varying between 30 and 62 years of age, the morphological aspects of the apical lesion were semilunar in 8 and mammillary in 6. Cardiac pacemakers were implanted in 8 cases due to complete A-V block in 6, to sinus node disfunction in 1, and to sinus arrest in 1. In 4 cases (28.57%) intraventricular thrombi were detected, in 3 occasioned thromboembolism to the brain. Thrombo-embolic phenomena occurred in the 11 nonsurvivors. The most frequent cause of death was heart failure in 8 followed by cerebro-vascular attacks in 3, after a follow-up period of 19 to 176 months.(ABSTRACT TRUNCATED AT 250 WORDS)