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Parasitic cardiomyopathies caused by Chagas disease and toxoplasmosis significantly impact cardiac health. Chagasic cardiomyopathy had lower mortality (12.5%) than toxoplasmic cardiomyopathy (42%), highlighting differing disease severity.
Area of Science:
- Cardiology
- Infectious Diseases
- Parasitology
Background:
- Parasitic infections can cause cardiomyopathy, leading to significant cardiac dysfunction.
- Chagas disease and toxoplasmosis are known etiologies of parasitic cardiomyopathy.
- Understanding the clinical presentation and outcomes of these conditions is crucial for patient management.
Purpose of the Study:
- To analyze and compare the clinical features, diagnostic methods, and mortality rates of parasitic cardiomyopathies.
- To differentiate outcomes between Chagasic and toxoplasmic etiologies.
- To provide insights into the progression and severity of these cardiac conditions.
Main Methods:
- Retrospective analysis of 51 patients with parasitic cardiomyopathies over 1-14 years.
- Diagnosis confirmed via serological studies and xenodiagnosis for Chagasic cases.
- Diagnosis for toxoplasmic cases involved periodical serological study with clinical correlation and parasite recovery in some instances.
Main Results:
- Chagasic etiology identified in 32 cases, toxoplasmic in 19. Chagasic cases showed cardiac insufficiency/arrhythmias (18/32) or precordial pain; mortality was 12.5%.
- Toxoplasmic cases presented with precordial pain/arrhythmias (14/19) or cardiac failure (13/19); mortality was 42%.
- Parasite recovery from myocardium/gland confirmed toxoplasmic etiology in 4 cases.
Conclusions:
- Toxoplasmic cardiomyopathy exhibits a significantly higher mortality rate compared to Chagasic cardiomyopathy.
- Both Chagasic and toxoplasmic infections present with diverse cardiac symptoms including arrhythmias and heart failure.
- Prompt diagnosis and understanding of etiological differences are vital for managing parasitic cardiomyopathies.
Abstract:
Fifty-one parasitic cardiomyopathies studied for periods ranging from 1 to 14 years were analyzed. In 32 cases chagasic etiology was demonstrated and in 19 cases toxoplasmic etiology. In the chagasic cases the diagnosis was confirmed by serological study and/or xenodiagnosis. In one of these patients an aneurysmatic dilatation of the left ventricular cavity was found. The clinic picture showed cardiac insufficiency and deleterous arrhythmias in 18 of the 32 cases. The rest of the patients had precordial pains. The mortality of the group was 12.5%. In toxoplasmic patients the diagnosis was made by periodical serological study, considering only those cases where concomitant clinical activity and pathological antibody response was demonstrated. In three cases the parasite was recovered from the myocardium and in another from a peripheral gland. The clinical picture in these groups consisted of precordial pain and arrhythmias in 14 cases, and cardiac failure in 13 cases. The mortality rate for the group was 42%.