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Title: Pathology of complete atrioventricular block in chronic Chagas’ myocarditis
Authors: Andrade, Zilton de Araújo
Andrade, Sonia Gumes
Sadigursky, Moysés
Affilliation: Fundação Gonçalo Moniz, Instituto de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Fundação Gonçalo Moniz, Instituto de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Universidade Federal da Bahia. Salvador, BA, Brasil
Abstract: Sclero-atrophy, fibrosis, vascular ectasia, phlebosclerosis and mild non-specific chronic inflammatory changes were observed in variable location and proportion involving the atrioventricular conducting tissue o f the heart in five human cases o f chronic Chagas’ myocarditis associated with complete atrioventricular block. One case presented complete destruction o f the A- V conduction system. In three cases the lesions were disseminated all along the conducting tissue but did not cause anywhere a complete disruption in the continuity o f the system. The distal portion o f the bundle branches were the most damaged sector o f the system, exceptfor the fasciculi o f the posterior division o f the left bundle branch which were relatively preserved. One case exhibited bilateral sclero-atrophy o f the bundle branches as the main change; and another showed early and mild fibrocalcific damage o f the penetrating portion o f the His bundle. The A -V node appeared as the least involved part o f the conducting system in the cases studied. Demonstration o f the lesions in this series o f cases seems important because: a) it reveals that complete atrioventriculr block in chronic Chagas’ disease results from disseminated lesions and not from fo ca l disruptive change as has been commonly observed in cases o f other etiologies; b) it shows that chronic inflammation can produce at the end variable and widespread vascular, degenerative andfibrotic alterations within the conducting tissue o f the heart, which may lead to its total destruction.
Keywords: Chronic Chagas’ myocarditis
Atrioventricular block
Issue Date: 1988
Publisher: Sociedade Brasileira de Medicina Tropical
Citation: ANDRADE, Z. A.; ANDRADE, S. G.; SADIGURSKY, M. Pathology of complete atrioventricular block in chronic Chagas’ myocarditis. Revista da Sociedade Brasileira de Medicina Tropical, v. 21, n. 1, p. 7-13, 1988.
ISSN: 0037-8682
Copyright: open access
Appears in Collections:BA - IGM - Artigos de Periódicos

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