Pathology of cardiomyopathy from South India

Abstract

Seven cases of cardiomyopathy are presented with detailed macroscopical and microscopical studies. There are some differences and also similarities between this group and those described by Davies from Uganda. Myocytolysis was present in all cases, and appeared earlier than endocarditis. The earliest endocardial lesion was smooth muscle hyperplasia. Feeding of monkeys with plantains for more than 8 months failed to produce any changes in the heart. After Bedford and Konstam (I946) described dilatation of the heart with subendocardial fibrosis and mural thrombosis (the latter being an inconstant feature) there were numerous reports relating to cardiac failure due to cardiomyopathies of unknown aetiology. Under differing nomenclature, various authors described obscure heart diseases from all over the world-Davies (1948) from Uganda, Gillanders (I95I) and Becker, Chatgidakis, and van Lingen (1953) from South Africa, Edington and Jackson (I963) from Nigeria, and Hill, Still, and McKinney (I967) from Jamaica, O'Brien (I954) from Sudan, Nagaratnam and Dissanayake (I959) from Ceylon, and Andrade and Guimaraes (I964) from Brazil. From India the necropsy reports on cardiomyopathy were reviewed by Reddy, Murthy, and Rao (I969). The World Health Organization has conducted three International Meetings to elucidate the problem of cardiomyopathies and published them in the Bulletin ofthe WorldHealth Organization in I965 and I968 and in the Chronicle of the World Health Organization in I967. At these meetings, mention was made of the common incidence of endomyocardial fibrosis in Kerala State in the lower West coast of South India, and that idiopathic cardiomegaly (a name suggested for all the other types of cardiomyopathies apart from endomyocardial fibrosis in the Kingston Conference of W.H.O. (I967)) was quite often seen in the Delhi area. The present report is a study of seven necropsy reports from the Deccan Plateau of South India. Material and methods In 20IO necropsies (excluding stillbirths) between August I960 and June i969, there were 220

Left ventricular endomyocardial fibrosis in India.

“…Material from 3 cases was later sent to Professor Davies in Uganda, who confirmed the diagnosis. After the publication of this work by Samuel and Anklesaria (1960) necropsy reports of endomyocardial fibrosis were published -from various parts of India (Shah et al, 1962;Mehrothra et al, 1964;Kinare and Deshpande, 1965;Reddy et al, 1965;Reddy et al, 1969;Reddy et al, 1970). They described involvement of both ventricles or the left ventricle alone.…”