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Chagas Cardiomyopathy in New Orleans and the Southeastern United States

Robert C Hsu1, Joshua Burak1, Sumit Tiwari1

  • 1Tulane University Heart and Vascular Institute, Tulane University School of Medicine, New Orleans, LA.

Ochsner Journal
|September 24, 2016
PubMed

Insights

Chagas disease (CD), a parasitic infection, can cause heart disease in individuals from endemic areas. Early diagnosis is crucial, especially in the US, as symptoms may mimic other cardiac conditions.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Parasitology

Background:

  • Chagas disease (CD), caused by Trypanosoma cruzi, affects millions globally and over 300,000 in the US.
  • CD presents with acute symptoms like fever and myocarditis, and chronic issues including cardiac, esophageal, and colonic damage.
  • Myocardial involvement in chronic CD is evident through ECG and MRI, showing inflammation and left ventricular dysfunction.

Observation:

  • Two cases of CD with cardiac manifestations were identified in the Southeastern US.
  • Case 1: Anginal chest pain and shortness of breath with myocardial involvement, normal coronary arteries.
  • Case 2: Asymptomatic patient with echocardiogram findings of reduced ejection fraction and regional wall motion abnormalities, normal coronary arteries.

Findings:

  • Both cases presented with cardiac abnormalities suggestive of ischemic heart disease but had normal coronary arteries.
  • These findings highlight the potential for Trypanosoma cruzi infection to mimic typical ischemic cardiac presentations.
  • The cases underscore the importance of considering CD in the differential diagnosis for unexplained heart conditions.

Implications:

  • Increased immigration from endemic regions necessitates greater awareness of Chagas disease in the US.
  • Clinicians should consider CD in patients with heart disease and a history of exposure to T. cruzi endemic areas.
  • Prompt diagnosis and management of Chagas disease can prevent severe cardiac complications and improve patient outcomes.
Abstract

Keywords:
Chagas cardiomyopathyChagas diseaseNew Orleans

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