Cardiac Disease of Obscure Origin in Africa

Abstract

Within recent years a number of papers have emanated from East, West, Central and South Africa, all reporting a form or forms of congestive heart failure, the etiology of which remains obscure. Interest in this subject began in 1946, when Bedford and Konstam published a series of 40 cases of unexplained heart disease in African troops, mostly from West Africa, serving in the Middle East. There were earlier references in the literature to peculiar aspects of heart disease in Africans. Although the cause may have been incorrectly attributed, the fact remains that these men had the good sense and courage to publish their findings. For instance, Macfie and Ingram (1920) reported the occurrence of cardiac aneurysm of uncertain cause in the African of the West Coast, which occurred in either childhood or adult life. The aneurysm could be situated in an auricle, ventricle or in one of the heart valves. It not frequently ruptured with the supervention of sudden death. In other cases the heart failed gradually.