“…Workers in various parts of the world, mainly in tropical and subtropical countries, have reported cases of unexplained cardiomegaly and cardiac failure under a variety of terms: cardiomegaly of unknown origin (World Health Organization, 1965), primary myocardial disease (Fowler, Gueron, and Rowlands, 1961), heart muscle disease (Edington and Jackson, 1963), idiopathic hypertrophy of the heart (Altman and Stein, 1956), cardiac disorders of unknown aetiology (Stuart and Hayes, 1963), cryptogenic heart disease (Higginson, Isaacson, and Simson, 1960), cardiomyopathy (Stein et al, 1964), idiopathic cardiomyopathy (Bloomfield and Liebman, 1963). These reports reveal a common feature of heart failure for which no definite cause can, be found, but they do not appear to be a homogeneous group aetiologically.…”