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[Apical left ventricular involvement in chronic Chagas' cardiopathy: clinical and ventriculographic aspects]
Insights
This study on Chronic Chagas
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Imaging
Context:
- Chronic Chagas' Heart Disease (CCHD) is a significant public health concern, particularly in endemic regions.
- Early diagnosis and characterization of cardiac involvement are crucial for managing CCHD.
- Left ventricular apical abnormalities are a hallmark of Chagasic cardiomyopathy.
Purpose:
- To investigate the prevalence and characteristics of apical left ventricular lesions in patients with Chronic Chagas' Heart Disease.
- To correlate apical lesions with clinical presentation, electrocardiographic findings, and heart failure status.
- To evaluate the diagnostic utility of left cineventriculography in identifying apical abnormalities in CCHD.
Summary:
- A study of 62 CCHD patients revealed apical left ventricular lesions in 83.87% via left cineventriculography.
- Common lesion morphologies included nipple-shaped, finger-like, and half-moon shapes, frequently associated with myocardial failure.
- Conduction defects were observed in 41 patients, and apical thrombi were detected in 3 patients.
Impact:
- Highlights the high frequency of apical left ventricular lesions in CCHD, underscoring their importance in disease progression.
- Provides detailed morphological characterization of apical lesions, aiding in their identification and classification.
- Emphasizes the role of advanced imaging techniques in assessing cardiac structure and function in Chagas disease patients.
Abstract:
The present study comprises 62 patients with Chronic Chagas' Heart Disease. In addition to clinical examination, serologic, roentgenologic, hemodynamic, electrocardiographic, left cineventriculographic and cinecoronariographic studies were performed, with subsequent evaluation apical left ventricule. Thirty two patients were women and 30 were men, varying between 21 and 64 years of age, all with positive serological tests, all with cardiovascular symptoms, 26 with myocardial failure (11 with left ventricular failure and 15 with congestive heart failure), heart size was normal on X-ray in 37 patients with cardiomegaly in 25 (slight in 10; moderate in 8 and accentuate in 7). The electrocardiogram revealed in 41 instance of conduction defects. The left ventriculogram showed an apical lesion in 52 patients (83.87%) with: localized hypokicinetic in 4 (6.45%), diffuse hypokicinetic in 6 (9.68%) and, apical lesion in 48 (77.42%). The shaped apical lesion as a nipple in 17 (27.42%), as finger in 17 (27.42%), and half-moon in 14 (22.18%). The apical lesion was observed in 20 of 26 patients with myocardial failure (76.92%). In 9 patients was associated with others aneurysms. In 3 patients apical thrombus was detected.