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Myocardial Lesions and Heart Failure in Infantile Malnutrition^*

Jorge Piza, Leon Troper, Rodolfo Cespedes, Joseph H. Miller AND Gerald S. Berenson^¶

Material from autopsies of 93 malnourished children, 3 months to 8 years old, was studied by light and electron microscopy for evidence of cardiovascular lesions. A high incidence of myocardial destruction, cardiac dilatation, and congestive heart failure was found. Striking histological changes were observed frequently in the myocardium and undoubtedly caused circulatory dysfunction. The marked myocardial changes were probably related to protein deficiency, although other nutritional factors could have contributed to severe changes. Appreciation of this evidence of myocardial damage is important in the clinical management of severe malnutrition, because congestive heart failure otherwise may be unrecognized and thus contribute to the high mortality of such children. A better understanding of the role of malnutrition in myocardial damage may contribute to understanding myocardial changes in other forms of myocardiopathy.

Accepted for publication September 22, 1970.

^* This investigation was supported by U.S. Public health Service grants TW 00148 and AI 02347 from the National Institute of Allergy and Infectious Diseases, and HE 02942 from the National Heart Institute.

Department of Pathology, Hospital San Juan de Dios, and the Faculty of Medicine, University of Costa Rica.

Louisiana State University, International Center for Medical Research (LSU-ICMRT), and the Faculty of Medicine, University of Costa Rica.

Department of Tropical Medicine and Medical Parasitology, L.S.U. Medical Center, New Orleans.

^¶ Department of Medicine, L.S.U. Medical Center, New Orleans.

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