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Trypanosomiasis, cardiomyopathy and the risk of ischemic stroke

Francisco Javier Carod-Artal1

  • 1Neurology Department, Hospital Vírgen de la Luz, Av. Hermandad Donantes de sangre s/n, 16002, Cuenca, Spain. fjcarod-artal@hotmail.com

Expert Review of Cardiovascular Therapy
|May 11, 2010
PubMed

Insights

Chagas disease (American trypanosomiasis) increases stroke risk, with cardioembolism being common. African trypanosomiasis may also pose stroke risks, requiring further study.

Area of Science:

  • Neglected tropical diseases
  • Neurology
  • Cardiology

Background:

  • American (Chagas disease) and African (sleeping sickness) trypanosomiasis are significant global health burdens.
  • Chagas disease is an independent risk factor for stroke, particularly ischemic stroke.
  • Stroke can be the initial presentation of Chagas disease, even without severe cardiomyopathy.

Purpose of the Study:

  • To highlight the association between Chagas disease and stroke.
  • To identify common stroke subtypes in Chagas disease patients.
  • To examine electrocardiographic findings in African trypanosomiasis and assess stroke risk.

Main Methods:

  • Review of clinical manifestations and risk factors for stroke in Chagas disease.
  • Analysis of stroke subtypes, focusing on cardioembolism.
  • Description of electrocardiographic alterations in African trypanosomiasis.

Main Results:

  • Cardioembolism affecting the middle cerebral artery is the most frequent stroke subtype in Chagas disease.
  • Apical aneurysm, heart failure, and arrhythmias are linked to ischemic stroke in chagasic cardiomyopathy.
  • Repolarization changes, low voltage, and prolonged QT intervals are prevalent in African trypanosomiasis (over 70% of patients).

Conclusions:

  • Chagas disease poses a substantial stroke risk, necessitating careful evaluation for recurrence.
  • Further epidemiological studies are required to determine the stroke risk associated with perimyocarditis in African trypanosomiasis.

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