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The imperfect storm: An uncommon presentation of Chagas disease

Matthew C Johnson1, Lulu Wang1

  • 1Department of Emergency Medicine, Medstar Georgetown University Hospital, United States of America.

The American Journal of Emergency Medicine
|August 12, 2022
PubMed

Insights

Electrical storm, a dangerous heart rhythm, can be challenging to treat. A case of electrical storm caused by Chagas disease was successfully managed with lidocaine, highlighting Chagas disease as a key consideration.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Electrophysiology

Background:

  • Electrical storm is a critical condition characterized by recurrent ventricular arrhythmias or defibrillator shocks within 24 hours.
  • Management of electrical storm is complex and often requires multi-faceted therapeutic approaches.
  • Chagas disease, a parasitic infection, is increasingly recognized in non-endemic regions due to population migration.

Observation:

  • A patient presented with an electrical storm, a condition defined as ≥3 sustained ventricular tachyarrhythmias or defibrillator shocks in 24 hours.
  • The patient's electrical storm was secondary to Chagas disease, an uncommon etiology.
  • The refractory electrical storm demonstrated responsiveness to intravenous lidocaine therapy.

Findings:

  • Lidocaine effectively controlled the life-threatening ventricular arrhythmias in this case of Chagas disease-induced electrical storm.
  • This case underscores the importance of considering Chagas disease in the differential diagnosis of new-onset heart failure and arrhythmias.

Implications:

  • Early diagnosis and management of Chagas disease are crucial to prevent severe cardiac complications like electrical storm.
  • Increased awareness and diagnostic vigilance for Chagas disease are warranted in patients with unexplained cardiac conditions, particularly in areas with South American immigration.
  • Lidocaine may represent a valuable therapeutic option for managing electrical storm in the context of Chagasic cardiomyopathy.

Keywords:
CardiologyElectrical stormEmergency medicineVentricular tachycardia

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