NUTRITIONAL HEART DISEASE

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Abstract
A form of congestive heart failure, believed by the author not to have been previously described was studied in 30 African adults. In addition to the evidence of congestive failure, the entire heart was enlarged, and fluoroscopically the pulsations were feeble; gallop rhythm, extreme edema, and liver enlargement were present (pigmentary cirrhosis). The diet of all patients was quantitatively and qualitatively deficient. In 5 patients the symptoms progressed even under good environment as long as they continued on the deficient diet. In all but the most advanced stages of the disease the heart decreased in size and the signs of failure subsided when a well balanced diet was administered. The plasma proteins were reduced to a critical level in only 2 patients. The heart in the autopsied cases had excessive weight and the walls of both ventricles were thickened. Microscopically there was inter-fibrillary edema but no hydropic degeneration. Hypertrophy of muscle fibers was present in both ventricles. The circulation times were usually prolonged and the venous pressure was only moderately elevated. The ecg. in some cases showed primary T wave changes which returned to normal after improvement.