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American trypanosomiasis (Chagas' disease): an unrecognised cause of stroke

F J Carod-Artal1, A P Vargas, M Melo

  • 1Neurology Department, Sarah Hospital, SMHS quadra 501, conjuntoA, Brasilia, Brazil 70330-150. fjcarod@aol.com.

Journal of Neurology, Neurosurgery, and Psychiatry
|March 18, 2003
PubMed

Insights

Chagas

Area of Science:

  • Cardiology
  • Neurology
  • Infectious Diseases

Background:

  • Chagas' disease (CD) is a significant cause of cardiomyopathy in South America, with cardiac damage manifesting years after infection.
  • The occurrence of cerebrovascular complications in individuals with chronic Chagas' disease remains largely uncharacterized.

Purpose of the Study:

  • To investigate the characteristics of ischemic stroke in patients with chronic or latent Chagas' disease.
  • To identify potential predictors of stroke occurrence within the Chagas' disease patient population.

Main Methods:

  • A retrospective case series design was employed to study stroke patients diagnosed with Chagas' disease.
  • Chagas' disease confirmation utilized immunofluorescence and hemagglutination serology.
  • Data included patient demographics, vascular risk factors, cardiac history, stroke type, and diagnostic imaging findings, with comparisons to a control group of non-chagasic stroke patients.

Main Results:

  • Among 136 Chagas' disease stroke patients, 81.6% had vascular risk factors. Notably, hypertension, diabetes mellitus, and tobacco use were less frequent than in controls.
  • Cardiomyopathy (45.58%) and abnormal electrocardiograms (82%) were significantly more prevalent in Chagas' disease stroke patients.
  • Common echocardiographic findings included left ventricular diastolic dysfunction (61.47%) and systolic dysfunction (51.18%). Cardioembolism was the leading stroke etiology (52.2%).

Conclusions:

  • Chagas' disease should be considered in the differential diagnosis for stroke, particularly in individuals from South America.
  • The study highlights a distinct profile of stroke in Chagas' disease patients, often linked to cardiac complications.
Abstract

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