title: [Chronic Chagas' cardiopathy causing congestive heart failure in childhood: a clinical and histopathological study of a case with emphasis on the lesions of the intracardiac conduction and autonomic nervous systems].
abstract: A case of decompensated chagasic cardiopathy in a nine-year-old boy from the south of the State of Goiás, is described. He developed congestive heart failure four months before death. The serological reaction for Chagas' disease and the xenodiagnosis were positive. Electrocardiograms showed sinusal tachycardia, ventricular and supraventricular extrasystoles, left anterior hemiblock, complete right bundle branch block and signs of chambers overload. The echocardiogram demonstrated chamber dilatation with diffuse hypocontractility. He presented a downhill course complicated with several pneumonic episodes, the last one just before death. At necropsy, the heart, exhibited a chronic pancarditis with fibrosing chronic myocarditis involving mainly the interventricular septum and left ventricle. The heart conduction system showed slight to moderate exudative, inflammatory changes. Scattered foci of slight chronic periganglionitis and rare degenerative phenomena of ganglionic cells were found in intracardiac autonomic nervous, without neuronal depopulation.
authors.affiliation: Disciplina de Patologia e Pediatria, Centro de Ciências Biomédicas, Universidade Federal de Uberlândia, MG.
authors.forename: A
authors.initials: A
authors.lastname: Rocha
authors.forename: J A
authors.initials: JA
authors.lastname: da Cunha
authors.forename: W
authors.initials: W
authors.lastname: Daud
authors.forename: R A
authors.initials: RA
authors.lastname: Heredia
authors.forename: H B
authors.initials: HB
authors.lastname: Gomes
authors.forename: O
authors.initials: O
authors.lastname: Mantese
authors.forename: A C
authors.initials: AC
authors.lastname: da Fonseca Neto
authors.forename: E R
authors.initials: ER
authors.lastname: Lopes
mesh_terms: D001341:Autonomic Nervous System / Q000473:pathology*; D002598:Chagas Cardiomyopathy / Q000473:pathology*; D002648:Child; D002908:Chronic Disease; D003937:Diagnosis, Differential; D006321:Heart / Q000294:innervation*; D006329:Heart Conduction System / Q000473:pathology*; D006333:Heart Failure / Q000473:pathology; D006801:Humans; D008297:Male; D009206:Myocardium / Q000473:pathology
vernacular_title: Cardiopatia chagásica crônica causando insuficiência cardíaca congestiva na infância: estudo clínico e histopatológico de um caso, com ênfase para as lesões dos sistemas excitocondutor e nervoso autônomo intracardíaco.