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https://www.arca.fiocruz.br/handle/icict/31650
HISTOPATHOLOGY OF THE CONDUCTING TISSUE OF THE HEART IN CHAGAS’ MYOCARDITIS
Miocardite chagásica
Eletrocardiograma
Humanos
Inflamação
Miocardite
Affilliation
University of Bahia. School of Medicine. Departments of Pathology and Medicine. Salvador, BA, Brazil.
University of Bahia. School of Medicine. Departments of Pathology and Medicine. Salvador, BA, Brazil.
University of Bahia. School of Medicine. Departments of Pathology and Medicine. Salvador, BA, Brazil.
Cornell University Medical College. New York, USA.
University of Bahia. School of Medicine. Departments of Pathology and Medicine. Salvador, BA, Brazil.
University of Bahia. School of Medicine. Departments of Pathology and Medicine. Salvador, BA, Brazil.
Cornell University Medical College. New York, USA.
Abstract
The conducting tissue of the heart was studied
in 25 human cases of Chagas’ myocarditis with a
method which employs complete serial sections
mounted on continuous transparent plastic tape.
The pathological changes were correlated with
electrocardiographic findings.
The inflammation of the acute phase of
Chagas’ myocarditis, as seen in one single case,
did not seem to interfere with conduction through
the AV system.
In chronic Chagas’ myocarditis the conducting
tissue showed extensive and variable changes:
chronic inflammation, fibrosis, atrophy and fragmentation
of specific fibers, extreme dilatation
and tortuosity of veins, capillaries and lymphatits,
fatty infiltration, and arterial medial and
intimal fibrosis.
A preferential involvement of the right bundle
branch and the anterior fascicles of the left
branch was observed and an excellent correlation
with electrocardiographic abnormalities was
found. There was also evidence presented that
bundle branch block may be caused by disease
proximal to the bundle branches.
Complete AV block seemed to be the final
result of the progressive inflammatory and degenerative
changes involving the conduction system
in chronic Chagas’ myocarditis.
Inflammation and fibrosis did also involve the
sinoatrial node, Purkinje fibers, intracardiac
nervous ganglia, and the contractile myocardium.
Keywords in Portuguese
Doença de ChagasMiocardite chagásica
Eletrocardiograma
Humanos
Inflamação
Miocardite
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