Mumps and the endocardium.
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Constrictive fibrous endocarditis is a pathological entity described by Loëffler in 1936. Its etiology is unknown. The clinical course is characterized by an evolution towards cardiac insufficiency leading rapidly to a fatal outcome. Moderen paraclinical investigations are necessary to assess the diagnostic. Caridac catheterization brings the proof of adiastole and angiogardiography reveals the shape of amputation of the ventricle with auriculoventricular regurgitation. The operative procedure consists of resection of the ventricular fibrosis including the valves and auriculo-ventricular valve replacement by a prosthetic valve. The disease affects both Caucasians and Negros. Our experience includes 5 cases. The indications for operation and their results are discussed.
We have described a case of congenital complete heart block associated with maternal primary Sjögren's syndrome. This diagnosis should also be considered when evaluating mothers of children with congenital heart block, especially when no connective tissue disease is otherwise clinically apparent. The potential significance of antibodies to SSA in this association remains to be determined.
A classification of the histological appearance of the endocardium in infants, and observers' reproducibility tests have been carried out. In a retrospective survey of 262 overtly normal hearts, what is considered to be abnormal thickening of the endocardium was found in 3.4%, and probably significant thickening in 20%. The changes occurred in unexpected home deaths as well as in hospital deaths and the lesions may be a contributing factor in some cot deaths, but a prospective study is required to confirm this.
A classification of the cardiomyopathies based on functional and morphological features is outlined, a detailed account of the pathology of each type is presented and possible pathogenetic mechanisms are reviewed. Myocarditis and its relationship to cardiomyopathy is considered and the main morphological and aetiological factors are presented.
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A validatory study of quantitative single plane left ventricular cineangiography is presented, using human left ventricular casts ranging in size from 1.6 to 135 ml. Good correlation was found between actual and calculated volumes (r=0.967). 62 patient studies were carried out and the value of the usually calculated indices of left ventricular performance were compared to one another. Ejection fraction and mean rate of circumferential fibre shortening (mean Vcf) were found to be the best discriminators of abnormal left ventricular function, and, on the basis of the presented data, it is suggested that mean Vcf is the more sensitive index of left ventricular performance.