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Chagas Heart Failure in Patients from Latin America

Reinaldo B Bestetti1

  • 1Department of Medicine, University of Ribeirão Preto,Ribeirão Preto, Brazil.

Cardiac Failure Review
|August 9, 2017
PubMed

Insights

Physicians should suspect Chagas heart failure in Latin American patients with chronic heart failure, confirmed by serology. Distinctive ECG, X-ray, and echocardiography findings aid diagnosis, with advanced treatments available for severe cases.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Tropical Medicine

Background:

  • Chagas disease, caused by *Trypanosoma cruzi*, is a significant cause of heart failure in endemic Latin American regions.
  • Increasing migration leads to a growing prevalence of Chagas heart failure (CHF) in non-endemic areas like Europe and the United States.
  • Early recognition and diagnosis of CHF are crucial for timely management and improved patient outcomes.

Purpose of the Study:

  • To outline diagnostic criteria for Chagas heart failure in patients presenting with chronic heart failure.
  • To describe the clinical course and management strategies for Chagas heart failure.
  • To highlight the role of advanced therapies in managing severe CHF.

Main Methods:

  • Review of clinical presentation, diagnostic tools, and treatment modalities for Chagas heart failure.
  • Analysis of characteristic electrocardiogram (ECG), chest X-ray, and echocardiography findings.
  • Evaluation of therapeutic interventions including medical management, device implantation, and heart transplantation.

Main Results:

  • Positive serology confirms Chagas disease in patients with chronic heart failure of Latin American origin.
  • Distinctive findings include right bundle branch block, left anterior fascicular block, enlarged cardiac silhouette without pulmonary congestion, and left ventricular apical aneurysm.
  • CHF has a poorer prognosis than non-Chagas heart failure, but medical treatment protocols are similar.

Conclusions:

  • Clinicians in Europe and the US must consider CHF in at-risk populations.
  • Specific diagnostic features aid in identifying this condition.
  • Advanced therapies like implantable cardioverter-defibrillators, cardiac resynchronization therapy, and heart transplantation are vital for managing CHF and sudden cardiac death prevention.

Keywords:
Chagas diseaseheart failureheart transplantationimplantable cardioverter-defibrillatorsudden cardiac death

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