Heart muscle disease among adult Nigerians: role of nutritional factors in its aetiology.

A study of 44 Nigerians with heart muscle disease defined as congestive cardiac failure and cardiac enlargement of unknown cause with a presenting diastolic blood pressure of not more than 100 mm Hg has shown 20 were alcoholics. 12 of these belonged to the high socioeconomic class. 17 were thiamine deficient; 11 of these consumed alcohol excessively and 8 of the 11 belonged to the high socioeconomic class. Only 3 alcoholics were identified in 52 controls. None of the 3 patients was thiamine deficient but 10 others were. Only 1 patient with heart muscle disease had a reversible high output cardiac failure. The mean serum albumin of the patients with heart muscle disease was significantly lower than controls. There was no significant difference between the mean levels of serum potassium in the study group and controls. It is concluded that chronic alcoholism is not rare among Nigerians with heart muscle disease. Although there is no convincing evidence to show that malnutrition or thiamine deficiency could in themselves cause the chronic myocardial failure seen in heart muscle disease, they could be conditioning factors which increase the susceptibility of the heart to other injurious agents.