The prognosis of idiopathic cardiomegaly in Jamaica with reference to the coronary arteries and other factors: clinical aspects - abstract

ABSTRACT

The mode of death, and the factors which appear to influence the prognosis of idiopathic cardiomegaly have been examined. In more than half the deaths in patients with idiopathic cardiomegaly, death was sudden or unexpected. Electrocardiograms recorded on patients with idiopathic cardiomegaly showed a high rate of abnormalities commonly regarded as indicative of coronary artery disease (36 percent in men and 50 percent in women), a high prevalence of cardiac arrhythmias, particularly multiple ventricular extrasystoles; and high voltage complexes characteristic of left ventricular hypertrophy. Fifty seven per cent of patients whose death was unexpected or sudden, showed multiple ventricular ectopic beats. The differences and similarities between idiopathic cardimegaly and coronary heart disease have been shown. It is concluded that the background of some cases of idiopathic cardiomegaly may be myocardial ischaemia occurring at a gradual and insidious pace, and probably diffusely involving a smaller category of coronary vessel. A possible role for intramuscular Lignocaine in the control of the chronic ventricular ectopic rhythms has been demonstrated. There was a statistically significant association between idiopatic cardiomegaly and positive serological tests for treponemal infection (AU)