Primary myocardial disease in infancy

Abstract

Fifteen cases of primary myocardial disease in infancy are presented and grouped as follows: 5 cases of acute primary idiopathic myocarditis (out of 57 which occurred during an epidemic outbreak in the Haifa area in 1956–1958); 4 cases of chronic idiopathic myocarditis; 3 cases of primary and secondary fibroelastosis; 2 cases of familial idiopathic cardiomegaly and 1 case of aberrant coronary artery. The clinical features, the electrocardiographic findings, and the radiologic appearances of the individual lesions are presented and discussed in relation to the histopathologic findings. An attempt is made to define the distinctive features of the individual entities, which would make clinical differentiation possible. The electrocardiographic tracings were found to be of great differential diagnostic value, the striking differentiating feature being the absence of signs of myocardial hypertrophy in myocarditis and the presence of such signs in the other entities. Radiologically there was severe passive pulmonary congestion in all cases of myocarditis in contrast to the other entities where congestion was absent or mild, except in the later stage. The histopathologic findings would seem to explain these differences.