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Development of chagas cardiac manifestations among Texas blood donors
Melissa N Garcia1, Kristy O Murray1, Peter J Hotez1
1Section of Tropical Medicine, Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas.
Insights
Chagas disease, caused by Trypanosoma cruzi, is emerging in the US. A study found 41% of infected blood donors had cardiac issues, suggesting cardiologists should consider this parasitic infection in diagnoses.
Area of Science:
- Infectious Diseases
- Cardiology
- Parasitology
Background:
- Chagas disease (Trypanosoma cruzi infection) is an emerging parasitic disease in the United States.
- Cardiac involvement is a significant concern in Chagas disease.
Purpose of the Study:
- To describe cardiac abnormalities in Trypanosoma cruzi-positive blood donors in southeastern Texas.
- To assess the prevalence of Chagas cardiomyopathy and potential local transmission.
Main Methods:
- Pilot study of T. cruzi-positive blood donors (2007-2012).
- Evaluated infection source, symptoms, comorbidities via questionnaire.
- Performed electrocardiography, echocardiography (if needed), and measured high-sensitivity troponin T.
Main Results:
- 41% of infected donors (7/17) showed electrocardiographic abnormalities indicative of Chagas cardiomyopathy.
- 36% of cases (6/17) were suspected to be locally acquired.
- High-sensitivity troponin T levels correlated with cardiac severity.
Conclusions:
- Cardiologists should include Chagas disease in differential diagnoses for unexplained cardiomyopathy or ECG changes.
- Consider Chagas disease even in patients without a history of living in endemic areas.
- Highlights the importance of screening and awareness of emerging parasitic infections.
Abstract:
Chagas disease, infection with the parasite Trypanosoma cruzi, has recently been identified as an important emerging parasitic disease in the United States. To describe the cardiac abnormalities in T. cruzi-positive blood donors in southeastern Texas, a pilot study of donors who had screened positive from 2007 to 2012 was performed. This one-time assessment included (1) a questionnaire to evaluate the source of infection, cardiac symptoms, and health co-morbidities; (2) electrocardiography; (3) echocardiography if electrocardiographic findings were abnormal; and (4) measurement of a high-sensitivity troponin T biomarker. Of those with confirmed infection, 41% (7 of 17) had electrocardiographic abnormalities consistent with Chagas cardiomyopathy. In addition, 36% (6 of 17) were suspected to be locally acquired cases. High-sensitivity troponin T serum levels increased with cardiac severity. In conclusion, cardiologists should consider Chagas disease in their differential diagnoses for patients who may have clinically compatible electrocardiographic changes or nonischemic cardiomyopathy, even if the patients have no histories of residing in Chagas-endemic countries.
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