Tuberculous dilated cardiomyopathy: an under-recognized entity?

Abstract

Background: Tuberculosis (TB) is a common public health problem in many parts of the world. TB is generally believed to spare these four organs-heart, skeletal muscle, thyroid and pancreas. We describe a rare case of myocardial TB diagnosed on a post-mortem cardiac biopsy.

Pathological Changes of Mycobacterium Tuberculosis and Treatments with Alcoholic Extract of Arachis hypogaea and Ethambutol in Mice

“…The mycobacterion tuberculosis spread through the blood stream to other tissues and organs and so all parts of body can be affected by the disease (Agarwal et al, 2005) and this agree with our result, that the M.O reach to different organs (lungs, liver, kidneys, intestine and spleen) .…”

“Death at the wheel” due to tuberculosis of the myocardium: a case report

“…Reasons for relative sparing of the myocardium include reference to the statement by Raviart regarding the protective effect of lactic acid produced by muscular activity of the myocardium [3,8]. According to Wallis et al, TB spreads to the myocardium by one of three methods: direct extension, retrograde spread via lymphatics from the mediastinal lymph nodes or by hematogenous route (from miliary disease) [11].…”

“…Generally, the pancreas, thyroid, heart and skeletal muscle are not afflicted by tuberculosis [3]. The first reported case of myocardial tuberculosis was by Maurocordat in 1664, followed almost a century later in 1761 in a report by from Morgagni [4].…”

Tuberculous Myopericarditis: A Rare Presentation in an Immunocompetent Host

“…Tubercular myocarditis can remain clinically asymptomatic (with a diagnosis being made at autopsy) or can present with sudden cardiac death, 4-6 intractable ventricular arrhythmias, long QT syndrome, 7 high-grade heart-block 8 or congestive heart failure. 9 Sudden cardiac death related to tuberculosis is rare and is usually attributable to bronchopneumonia and complications of pulmonary cavitation leading to massive haemoptysis from rupture of Rasmussen's aneurysm. 10 Increasing recognition of the entity and the use of endomyocardial biopsy may help in detecting more cases of such a curable form of cardiomyopathy.…”