Cardiac tuberculosis. A study of 19 patients

Myocardial tuberculosis (TB) was encountered in 19 patients (0.14%) at autopsy over a 27-year period. Eight patients had miliary lesions, and 11 had nodular lesions. Myocardial TB was diagnosed ante mortem in only one patient. Three patients developed left ventricular aneurysms. Tuberculous lesions were most commonly observed in the ventricles. Nodular tuberculous lesions produced no significant cardiac dysfunction, and the severe systemic symptoms of patients with miliary TB overshadowed the effects of cardiac miliary TB. Two additional patients with disseminated TB showed a focal lymphocytic myocarditis unassociated with diagnostic tuberculous lesions in the heart. This myocarditis differed histologically from the diffuse myocarditis described in the older literature.