disease has primary infectious agent disease disrupts disease causes disruption of selenium compound metabolic process Keshan disease https://github.com/monarch-initiative/mondo/issues/3205 https://rarediseases.info.nih.gov/diseases/8761/keshan-disease https://www.malacards.org/card/keshan_disease The etiological mechanism of KD remains largely unclear, selenium and Coxsackie virus infection have been suggested to be highly involved in the pathogenesis of KD [PMID:33634251]. A congestive cardiomyopathy caused by a combination of dietary deficiency of selenium and the presence of a mutated strain of Coxsackievirus. enlarged heart and poor heart function MEDGEN:78639 MONDO:0000241 icd11.foundation:1307765114 UMLS:C0268095 SCTID:46939000 congestive cardiomyopathy due to selenium deficiency ICD9:269.3 MESH:C536166 GARD:0008761 DOID:0050083 cardiomyopathy infectious disease coxsackievirus infectious disease nutritional deficiency disease Coxsackievirus