Cardiopatia chagásica crônica em pacientes na faixa de 12 a 15 anos / Chronic Chagas cardiopathy in patients between 12 to 15

RESUMO

Comparar os aspectos anátomo-patológicos da cardiopatia chagásica crônica (CCC) em adolescentes e adultos. De 4.583 autópsias realizadas no Serviço de Anatomia Patológica do Hospital Professor Edgard Santos, entre 1958 e 1986, foram estudados pacientes até os 15 anos de idade, com amastigotas em miocárdio, xenodiagnóstico e/ou sorologia positiva para Doença de Chagas. Foram identificados nove portadores de CCC, com idades entre 12 e 15 anos. O peso do coraçäo näo ultrapassou o dobro do normal. Trombos intracardíacos estavam presentes em cinco (55,6%), aneurisma da ponta do ventrículo esquerdo em quatro (44,4%) e parasitas no miocárdio em três (33,3%) dos casos. Embolia pulmonar ou sistêmica foi diagnosticada em seis (66,7%) pacientes. Insuficiência mitral estava presente em seis (66,7%) casos, com lesäo valvar em dois. A CCC que ocorre na adolescência näo difere em seus aspectos patológicos da doença na fase adulta

ABSTRACT

Purpose - A comparison between pathological features of chronic chagasic cardiomyopathy (CCC) in adolescents and adults. Patients and Methods - Adolescents under the age of 15, with amastigote trypanosomal forms in the myocardium, a positive zenodiagnosis and/or sorology for trypanosoma cruzi infection, were selected from 4.583 necropsies performed between 1958-86 at the Professor Edgard Santos Hospital in Bahia, Brazil. Results - Nine CCC cases between the ages of 12 and 15 years were identified. Mean heart weight was under twice normal. Intracardiac thrombi were present in five (55.6%), apical left ventricle aneurysm in four (44.4%) and parasytes in the myocardium in three (33.3%) cases. Systemic or pulmonary thromboembolism was found in six (66.7%) patients. Mitral regurgitation was present in six (66.7%) cases, two with valvar anatomic alterations. Conclusion - Pathological features of CCC in adolescents did not differ from those found in adult patients.