Chagas heart disease: report on recent developments

Fabiana S Machado1, Linda A Jelicks, Louis V Kirchhoff

  • 1Department of Biochemistry and Immunology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil.

Cardiology in Review
|February 2, 2012
PubMed

Insights

Chagas disease, caused by the parasite Trypanosoma cruzi, leads to significant cardiac issues like cardiomyopathy and heart failure. Management focuses on symptoms, as antiparasitic treatment may not be suitable for advanced cases.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Parasitology

Background:

  • Chagas disease, caused by Trypanosoma cruzi, is a major cause of cardiac disease in Latin America.
  • Increasing immigration leads to Chagas disease diagnoses in nonendemic regions.
  • Cardiac manifestations include dilated cardiomyopathy, heart failure, arrhythmias, cardioembolism, and stroke.

Purpose of the Study:

  • To define the pathology of Trypanosoma cruzi infection.
  • To elucidate cellular and molecular mechanisms of Chagas heart disease.
  • To inform clinical management strategies for Chagas heart disease.

Main Methods:

  • Clinical research on Chagas disease patients.
  • Laboratory-based investigations into T. cruzi infection pathology.
  • Review of existing literature on Chagas heart disease management.

Main Results:

  • Research has illuminated cellular and molecular pathways in T. cruzi-induced cardiac pathology.
  • Antiparasitic treatment may be contraindicated in advanced Chagas heart disease.
  • Cardiac transplantation is a viable option for select patients.

Conclusions:

  • Chagas heart disease presents with diverse cardiac complications.
  • Management parallels other cardiomyopathies; antiparasitic therapy is context-dependent.
  • Cardiac transplantation offers a therapeutic avenue for end-stage Chagas heart disease.

Related Concept Videos

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
Ischemic Heart Disease: Overview01:17

Ischemic Heart Disease: Overview

Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and narrowing...
Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...