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Multimodal Cardiac Imaging of a Sudden Cardiac Death Survivor From Central America

D Douglas Miller1, Gyanendra K Sharma1, Sam Natla1

  • 1Medical College of Georgia, Augusta, Georgia, USA.

JACC. Case Reports
|June 27, 2025
PubMed

Insights

Chagas cardiomyopathy, a complication of Trypanosoma cruzi infection, significantly increases the risk of sudden cardiac death (SCD). Multimodal cardiac imaging aids in managing this condition and preventing SCD.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Imaging

Background:

  • Sudden cardiac death (SCD) in an individual from El Salvador with exposure to Trypanosoma cruzi-seropositive siblings raised suspicion for Chagas disease.
  • Chagas disease, caused by Trypanosoma cruzi, is endemic in many regions and can lead to cardiac complications.

Observation:

  • A 61-year-old male SCD survivor presented with conduction abnormalities, cardiomegaly, and myocardial necrosis.
  • Echocardiography and left ventriculography revealed myocardial necrosis with aneurysm formation and sluggish contrast flow without coronary obstruction.
  • Cardiac magnetic resonance imaging demonstrated myocardial fibrosis and microvascular disease, guiding endomyocardial biopsy.

Findings:

  • Serological studies for T. cruzi and inflammatory markers supported a diagnosis of late-stage Chagas cardiomyopathy.
  • The patient exhibited features consistent with Chagas cardiomyopathy, a known risk factor for SCD.

Implications:

  • Multimodal cardiac imaging is crucial for early management of Chagas cardiomyopathy in SCD survivors.
  • Imaging guides antiparasitic therapy to slow disease progression and aids in risk stratification for secondary prevention with implantable cardioverter defibrillators.
  • This approach improves prognosis and reduces the risk of SCD in high-risk patients.
Abstract

Keywords:
cardiac magnetic resonancecardiomypathycoronary angiography

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