Cerebral infarction in autopsies of chagasic patients with heart failure

ABSTRACT

OBJECTIVE: To determine the frequency of encephalic infarction and its contribution to lethality in patients with Chagas' disease and heart failure. METHODS: Medical records and autopsy reports of patients with Chagas' disease complicated by heart failure, who died at the Professor Edgar Santos Hospital of the Federal University of Bahia in the past 45 years were retrospectively analyzed. Data comprised information regarding the clinical history on hospital admission, complementary and anatomicopathological examinations, including the presence of encephalic infarction, the impaired region, and the cause of death. RESULTS: Of the 5,447 autopsies performed, 524 were in patients with heart failure due to Chagas' disease. The mean age was 45.7 years, and 51 (63 percent) patients were of the male sex. The frequency of encephalic infarction was 17.5 percent, corresponding to 92 events in 92 individuals, 82 (15.8 percent) of which involved the brain, 8 (1.5 percent) involved the cerebellum, and 2 (0.4 percent) involved the hypophysis. CONCLUSION: Cerebral infarction has been a frequent finding in autopsies of chagasic patients with heart failure, and it has been an important cause of death in our region. The presence of cerebral infarction and its complications have been associated with death in 52 percent of the cases studied