Tuberculosis is rampant in our country ( of course in any developing country ). Many of the patients who are referred for cardiac failure has history of pulmonary tuberculosis.
In our echo lab we handle 100s of patients every month from the regional TB sanatorium . While the clinical presentation mimics COPD , many of them have be severe bi-ventricular dysfunction in echocardiography and bulk of them satisfy the criteria for dilated cardiomyopathy . So what are we missing ? or guessing ?
The following paper which finds a strikingly similar observation . . . is important for many reasons
- It comes for a prestigious Institute from India (PGIMS Chandigarh)
- It strongly suggest the link between DCM and tuberculosis
- It also tells us both can be completely curable.
We know cardiac failure is a relentlessly progressive disease . We also know , certain forms of DCM are reversible especially infectious and toxic ones .Whenever we ask our residents (Bitten by the western bug !) for causes of reversible cardiomyoapthy they promptly rattle out exotic conditions like selenium deficiency and cobalt cardiomyopathy etc ,
we tend to forget “a big possibility of tuberculosis” as cause for reversible cardiomyopathy.
Students are not be blamed ,we have never taught them to think in Indian perspective !
Finale
DCM is a biggest cardiac problem in our country next only to CAD. While our country men suffer , we are perennially happy to label them as idiopathic DCM , even as we continue to loose our precious time every day , in ballooning dubious lesions in hi -tech cath labs and help fill the corporates coffers !
I entirely agree with the authors , DCM due to Tuberculosis is a hugely under-recognised entity in a country with over 12o0 million people. So , youngsters are argued to find answers to this burning issue . (* I am afraid how many of us are aware of such an important article published from India. )
We propose to under take a study from from Chennai tuberculosis research center about this. Any body wishing to fund this project ?
How does tuberculosis affect heart muscle ?
Will be posted soon .
Dr.S.Venkatesan MD 
I had a relative who had dilated cardiomyopathy with profound hypokinetic heart.PET CT show suspicious lymph nodes in mediastinum and neck.all other tests were negative.cervical node biopsy showed epitheloid cells with necrosis -consistent with TB.Mantoux was also borderline.However AFB was negative.so it was concluded to be tuberculous and now patient is in ATT.waiting for response.Sir I want to know how does it affect cardiac cells?and where is the study going on?thanks