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Heart Failure Secondary to Chagas Disease: an Emerging Problem in Non-endemic Areas
Mahmoud Traina1,2, Sheba Meymandi1, Jason S Bradfield3,4
1Center of Excellence for Chagas Disease, Olive View-UCLA Medical Center, 14445 Olive View Dr., Sylmar, CA, 91342, USA.
Insights
Millions are affected by Chagas disease, a parasitic infection. Underdiagnosis in non-endemic regions leads to delayed treatment and increased risk of severe cardiac complications like heart failure.
Area of Science:
- Neglected tropical diseases
- Cardiology
- Infectious diseases
Background:
- Chagas disease impacts millions globally, primarily in South America, Central America, and Mexico.
- While many infected individuals are asymptomatic, 30% develop cardiac issues, including heart failure.
- Immigration spreads Chagas disease to non-endemic regions, where healthcare providers often lack diagnostic and treatment experience.
Purpose of the Study:
- To highlight the challenges in diagnosing and treating Chagas disease in non-endemic countries.
- To underscore the negative impact of underdiagnosis on patient outcomes and healthcare costs.
- To emphasize the increased risk of cardiomyopathy, heart failure, and arrhythmias due to delayed diagnosis.
Main Methods:
- This study is a review of the current understanding of Chagas disease epidemiology and clinical presentation.
- Analysis of the implications of underdiagnosis in non-endemic healthcare settings.
- Discussion of the progression of cardiac manifestations in untreated Chagas disease.
Main Results:
- Healthcare providers outside endemic areas frequently lack experience with Chagas disease.
- Underdiagnosis is prevalent in non-endemic countries, leading to poorer patient outcomes.
- Delayed diagnosis exacerbates the risk of developing severe cardiac conditions and potentially fatal arrhythmias.
Conclusions:
- Effective diagnosis and management of Chagas disease in non-endemic regions are critical.
- Increased awareness and specialized training are needed to address the diagnostic gap.
- Timely intervention can mitigate the progression to advanced cardiac disease and improve patient prognosis.
Abstract:
Chagas disease affects millions of people worldwide. Though the majority of infected individuals remain asymptomatic, approximately 30 % of patients progress to develop cardiac manifestations and eventual heart failure. While vectorial transmission occurs predominantly in South America, Central America, and Mexico, millions of people originally from these endemic regions immigrate to non-endemic countries in North America, Europe, and Asia. Outside of rare specialized centers, health-care providers lack experience diagnosing and treating this disease. This lack of experience likely leads to far fewer Chagas disease patients being diagnosed than what actually exist in non-endemic countries, with subsequent adverse effect on patient outcomes and health-care expenses. Underdiagnosis increases the risk of developing cardiomyopathy, associated heart failure, and life-threatening ventricular arrhythmias as the disease progresses.
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