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Cardiac involvement in Whipple's disease.

H A McAllister, J J Fenoglio

    Circulation
    |July 1, 1975
    PubMed
    Summary

    Whipple's disease frequently causes significant cardiac problems, including inflammation and fibrosis of the heart muscle and valves. Early recognition of cardiac symptoms is crucial for managing this rare bacterial infection.

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    Area of Science:

    • Cardiology
    • Infectious Diseases
    • Pathology

    Background:

    • Cardiac involvement in Whipple's disease is often underestimated.
    • Previous reports have not emphasized the extent and significance of cardiac manifestations.

    Purpose of the Study:

    • To investigate the prevalence and characteristics of cardiac involvement in Whipple's disease.
    • To highlight the pathological findings and clinical significance of cardiac lesions.

    Main Methods:

    • Autopsy and histological examination of cardiac tissues from 19 Whipple's disease patients.
    • Clinical assessment including physical examination, ECG, and echocardiography.
    • Electron microscopy to identify causative microorganisms.

    Main Results:

    • 58% of patients exhibited clinical cardiac findings; 79% had gross cardiac lesions at autopsy.
    • PAS-positive macrophages, inflammation, and fibrosis were observed in the pericardium, myocardium, and valves.
    • Cardiac deformities resembled those seen in rheumatic heart disease and idiopathic cardiomyopathy.
    • Rod-shaped bacteria, consistent with Tropheryma whipplei, were identified in cardiac tissues.

    Conclusions:

    • Whipple's disease causes a pancardiopathy with significant structural damage.
    • Cardiac involvement is a major feature of Whipple's disease, leading to various clinical manifestations.
    • Identification of bacteria in cardiac tissue confirms their role in the observed pathology.

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