Cardiomiopatías: Estudio de 25 casos y revisión de la bibliografía

Abstract

Twentyfive patients with cardiomyopathy coming from different regions of Peru have been studied the majority (22) at the Hospital Dos de Mayo in the city of Lima. Twentythree were males and two females, and their ages were between 13 and 65 years. Twelve patients belonged to the idiopathic cardiomyopathy, 8 were related to alcoholism, 3 belonged to the familiar type, one case was a of post-partum cardiomyopathy and another of endomyocardial fibrosis.

The selection was made taking into account the existence of heart failure, embolism or arrhythmia, in patient in which the common causes of heart disease were ruled out. A clinical, electrocardiographic and radiologic study was performed in every case. Some laboratory test were also done, including a serelogical one for Chagas' disease in 10 cases. Fourteen patients died and necropsy was carried out in each of them. 

Findings related to heart failure were seen in almost every case, in just one patient the whole symptomatology was related to systemic embolism. Different electrocardiographic paterns were observed although a combination of intraventricular block with low voltaje was recorded in several cases. Radiological evidence of left ventricular and atrial enlargement was also a frequent finding. Laboratory tests were of no help and the 10 patients tested for Chgas' disease yielded negative results. Pathological findigs wil be discussed in a separate paper. 

It is concluded that the cardiomyopathies are not rare diseases, appearing at any age and easy to be mistaken for orner types of heart disease. In symptomatic patients the diagnosis is made on clinical grounds with adequate suport from the electrocardiogram; this is very useful also as a screening method. The etiology of the myocardial diseases is still not well unsderstood. Chagas' disease does not seem to be an important etiological factor in the area of Lima, chronic alcoholism deserves further study to conclude on its apparently important role.