[Ventricular aneurysm in chronic Chagas' disease. The experience of the Instituto Nacional de Cardiología Ignacio Chávez]. / Aneurisma ventricular en la cardiopatía chagásica crónica. Experiencia del Instituto Nacional de Cardiología "Ignacio Chávez".

This work describes the incidence of ventricular aneurysms in patients with angiographically normal epicardial coronary arteries, who have epidemiological, clinical and serologic features suggesting chronic Chagasic cardiomyopathy (C.C.C). Eight out of 22 patients (36%) with such features had ventricular aneurysm. Three were located on the apex, 3 anteroapical and 2 basal. All patients had arrhythmia. In a case it was necessary a surgical approach to control a medically intractable life threatening ventricular tachyarrhythmia. In regard of the incidence of ventricular aneurysms in C.C.C., our results are in agreement with published experiences in South America. Surgical treatment of chagasic aneurysm should be considered when medical treatment is unable to control dangerous arrhythmia and an electrophysiological study supports this approach.

[The aortopulmonary window. A report of 4 cases]. / Ventana aortopulmonar. Reporte de 4 casos.

The aortopulmonary window is a rare congenital disease in which the aorta and pulmonary arteries are communicated by a defect of variable diameter. We review the clinical picture, diagnosis, associated lesions and treatment of four patients with this disease in a period between 1980 and 1990. Two patients had a distal and two a proximal type. There were associated lesions in three patients: Aortic arch interruption type A, patent ductus arteriosus, subaortic stenosis and a ventricular defect. All patients underwent surgical correction of a communication between 12 and 15 mm of diameter. We discuss diagnostic problems and treatment of this congenital disease.

[American trypanosomiasis and chronic Chagas cardiopathy at the "Ignacio Chaves" National Institute of Cardiology]. / Tripanosomiasis americana y cardiopatia chagásica crónica en el Instituto Nacional de Cardiologia Ignacio Chavez.

The cumulated experience at the Instituto Nacional de Cardiolog ía Ignacio Chavez during the period from 1977 to 1988 in regard of American Trypanosomiasis (AT) and its sequelae, chronic Chagasic Cardiopathy (CHC) was reviewed. There are 39 cases. One was an acute myocarditis in a child 16 months old. Three, subacute diseases among young patients and 35 cases of chronic disease with severe heart compromise. Heart failure was the most important manifestation in 19 patients. Arrhythmia was the dominant one in 8 cases. Both conditions did occur in 8, 2 had Stokes Adams syndrome as presenting complaint and one had pulmonary embolism. The surface EKG was always abnormal and heart enlargement was noted in 36 cases on chest X rays. All patients had serologic evidence of antitrypanosoma antibodies, 28 had heart reactive antibodies in their serum, 24 had polyclonal hypergammaglobulinemia and the same proportion had rheumatoid factor. Only the acute case showed another non-organ specific autoantibody. Echocardiography was useful to show dilatation of all cavities, left ones were more severely affected, abnormal movement was also detected with lower frequency, apical aneurysm and left ventricular hypertrophy were rarely detected. Fifteen out of 16 cases studied by angiogram did show normal coronary arteries, abnormal movement was demonstrated in 62% and apical aneurysm was present in 4 cases. Studies with EKG monitoring (Holter) and electrophysiology confirmed electrical abnormalities. Although once considered an exotic disease, CHC is probably underdiagnosed because the lack of methodic studies looking for epidemiologic, clinical and seroimmunologic features in patients with dilated myocardiopathy. Cardiologist practicing in south and southeast states in Mexico should be aware of this heart ailment.(ABSTRACT TRUNCATED AT 250 WORDS)