IDIOPATHIC CARDIAC HYPERTROPHY WITH ENDOMYOCARDIAL FIBROSIS: REPORT OF A CASE DEVELOPING AFTER RECOVERY FROM A PURULENT LUNG ABSCESS

Abstract

The case is reported because it is the first example of this disorder appearing and progressing in a patient who initially manifested no evidence of cardiovascular disease. Fifteen months after recovery from a purulent lung abscess, the patient presented with manifestations of right- and left-sided heart failure as well as an enlarged heart and a gallop rhythm. Initially, he responded to digitalis and diuretic therapy. Diagnostic procedures revealed no obvious etiology for the heart disease. The patient''s course was followed for a period of 33 months during which he suffered from congestive heart failure, until death due to myocardial failure, recurrent pulmonary infractions, and a secondary cor pulmonale. Autopsy revealed dilatation of all cardiac chambers. There was endomyocardial thickening due to fibrosis; and there were small foci of myocardial necrosis. A review of the literature revealed that this disease is common in Africa. Attention in this case is drawn to the large doses of digitalis used without producing digitalis intoxication; thus aiding to distinguish this disorder from myocarditis.