Idiopathic cardiomegaly in Ceylon. Congestive cardiac failure, cardiomegaly, hepatomegaly, and portal fibrosis associated with malnutrition.

Cardiomyopathy or primary myocardial disease is being recognized with increasing frequency and different clinical syndromes belonging to this group of diseases have been described from various parts of the world. Amongst the causes reported are familial, inflammatory, allergic, toxic, nutritional, metabolic, cardiomyopathy associated with various systemic diseases, blood dyscrasias, collagen, malignant, and neuromuscular disorders. However, in the vast majority of cases no definite cause can be attributed. While all patients who suffer from cardiomyopathy manifest a number of similarities, there are a number of important differences that help to distinguish them. This paper describes a well-defined clinical syndrome seen in Ceylonese patients with poor nutritional background, manifesting signs ofmalnutrition, congestive cardiac failure, cardiomegaly of unknown aetiology, hepatomegaly with portal fibrosis, and abnormal serum proteins. They were thought to be suffering from idiopathic cardiomegaly. The clinical picture in 28 such patients, post-mortem appearances in 4, and a comparison of their incomes, dietary habits, liver biopsy appearances, plasma protein electrophoretic patterns, biochemical, and blood picture studies, with patients suffering from congestive failure secondary to ischaemic,rheumatic, and hypertensive disease, is described. The latter patients served as controls.