Echocardiographic recognition of Chagas' disease and endomyocardial fibrosis
1Department of Medicine, University of California, San Francisco 94143-0214.
Insights
Recognizing Chagas' heart disease and endomyocardial fibrosis in nonendemic areas is challenging due to unfamiliar echocardiographic patterns. This article details characteristic findings to aid diagnosis of these rare conditions.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Chagas' heart disease and endomyocardial fibrosis are prevalent in Central/South America, but rare in North America.
- Lack of familiarity with their echocardiographic patterns hinders recognition in nonendemic regions.
Purpose of the Study:
- To present characteristic echocardiographic findings of Chagas' heart disease and endomyocardial fibrosis.
- To facilitate earlier recognition of these conditions in nonendemic areas.
Main Methods:
- Review of echocardiographic features of Chagas' heart disease.
- Review of echocardiographic features of endomyocardial fibrosis.
Main Results:
- Chagas' heart disease: characteristic left ventricular apical aneurysm with minimal septal involvement.
- Endomyocardial fibrosis: apical obliteration, small left ventricular cavity, enlarged atria, and atrioventricular valvular insufficiency.
Conclusions:
- Echocardiography is crucial for identifying Chagas' heart disease and endomyocardial fibrosis.
- Familiarity with specific echocardiographic patterns aids diagnosis in nonendemic settings.
Abstract:
Chagas' heart disease and endomyocardial fibrosis are common medical conditions in Central and South America but are only rarely encountered in North America. In the small number of patients who have these conditions, recognition is frustrating because of a lack of familiarity with their characteristic echocardiographic pattern. In Chagas' heart disease a left ventricular apical aneurysm is characteristic, but in contrast to coronary artery disease, septal involvement is minimal. In endomyocardial fibrosis apical obliteration with a small inwardly moving left ventricular cavity, large atria, and atrioventricular valvular insufficiency are typical features. It is the aim of this article to present the characteristic echocardiographic findings with these conditions and thereby facilitate the recognition when they appear in nonendemic areas.
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