title: [Apical lesions in Chagas' heart disease patients: an autopsy study].
abstract: BACKGROUND
  The presence of an apical ventricular lesion increases the risk of intracardiac thrombosis and thromboembolic phenomena. The study evaluated the incidence of apical lesions and intracardiac thrombosis in Chagas' heart disease patients at autopsy.
  
  
  METHODS
  A retrospective review of autopsies of Chagas' heart disease patients was conducted. Statistical analysis included comparison of clinical variables and autopsy findings between two groups: group A (apical lesions) and group B (no apical lesions).
  
  
  RESULTS
  A total of 51 cases of Chagas' disease patients were studied: 25 in group A (mean age 53 years-old; 64% male) and 26 in group B. Apical lesions were verified in the left ventricle in 80% of cases. The prevalent clinical subtype in both groups was myopathic, but significant cardiac arrhythmia was present in 57.9% of patients in group A, while 76.9% in group B did not present arrhythmias. Mean heart weight was 500.9 g in group A and 408.4 g in group B. The presence of thrombosis occurred in 60% of group A with 8 (53.3%) thrombi occurring in the apical lesion.
  
  
  CONCLUSIONS
  The myopathic subtype was the most common clinical form in group A and the mean heart weight was statistically higher in this group. Clear prevalence of thrombosis was verified in group A, with 50% located in the apical lesion, whose main differential factor was a greater incidence of arrhythmias. Myopathy (heart weight above 500 g) was primordial for the presence of thrombosis in both groups.
authors.affiliation: Centro de Ciências da Vida, Faculdade de Medicina, Pontifícia Universidade Católica, Campinas, SP. cbfmgurgel@ig.com.br
authors.forename: Cristina Brandt Friedrich Martin
authors.initials: CB
authors.lastname: Gurgel
authors.forename: Maria Cristina Furian
authors.initials: MC
authors.lastname: Ferreira
authors.forename: Clayde Regina
authors.initials: CR
authors.lastname: Mendes
authors.forename: Elaine
authors.initials: E
authors.lastname: Coutinho
authors.forename: Priscila
authors.initials: P
authors.lastname: Favoritto
authors.forename: Fernanda
authors.initials: F
authors.lastname: Carneiro
mesh_terms: D001344:Autopsy; D002598:Chagas Cardiomyopathy / Q000473:pathology*; D002908:Chronic Disease; D005260:Female; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D012189:Retrospective Studies