الفهرس 
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Abstract
Protein energy malnutrition (PEM) is undoubtedly one of the most prevalent nutritional problems in underdeveloped countries (Trowell et al., 1954 and Alleyne et al., 1977).
The (PEM) is regarded as a spectrum of diseases arising frdm an inadequate diet both in quality and/or quantity. It occurs during the first three years of life. The deficiency of calories and proteins in PEM affects tissue protein dud fat throughout the body with pronounced loss of depot fat and wasting of skeletal muscles (Smyth et al., 1962).
Malnutrition stunts growth and produces generalized tissue wasting, particularly a severe loss of muscle tissue and protein,which almost certainly includes the heart muscle. The syndrome of kwashiorkor (protein energy malnutrition) is characterized by oedema, as well as tissue loss, skin, hair, and mood abnormalities (MaCalice, 1971).
Many children succumb during the course of the illness without an apparent cause. The suddenness of this event suggest, the possible occurrence of heart failure or cardiac tamponade (Sims, 1972).