open access

Vol 15, No 6 (2008)
Review articles
Published online: 2008-09-22
Submitted: 2013-01-14
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Chagas disease: State-of-the-art of diagnosis and management

Sérgio Dubner, Edgardo Schapachnik, Andrés Ricardo Pérez Riera, Elina Valero
Cardiol J 2008;15(6):493-504.

open access

Vol 15, No 6 (2008)
Review articles
Published online: 2008-09-22
Submitted: 2013-01-14

Abstract

Chagas’ disease or American trypanosomiasis, is a potentially lethal parasitic zoonosis prevalent and endemic only in Latin America, caused by the flagellate protozoa Trypanosoma cruzi. It has 3 differents stages, acute, indeterminate and chronic phase, with the chance of an etiological approach in the first stage and pharmacological and non-pharmacological treatment in the chronic phase. There are five main clinical forms of chronic chagasic cardiomyopathy: indeterminate, arrhythymogenic (predominantly dromotropic and extrasystolic), with ventricular dysfunction, thromboembolic and mixed forms. There are several diagnostic tests at the different stages, however, the ECG is the method of choice in longitudinal population studies in endemic areas because it is simple, with a low cost and a good sensitivity. Microscopic examination or parasitological diagnosis in the acute phase or immunodiagnostic tests are used to confirm the disease. The antiarrhythmic drug amiodarone, the most frequently prescribed agent for symptomatic ventricular arrhythmia treatment of Chagas’ disease patients, has also recently been shown to have antifungal activity. Cardiac device implantation is very common, and chronic Chagas disease patients require pacemaker implantation at a younger age in contrast with patients with other cardiac pathologies. In summary, Chagas disease is a social disease, endemic in Latin America and shows different prevalence rates in Latin American countries.

Abstract

Chagas’ disease or American trypanosomiasis, is a potentially lethal parasitic zoonosis prevalent and endemic only in Latin America, caused by the flagellate protozoa Trypanosoma cruzi. It has 3 differents stages, acute, indeterminate and chronic phase, with the chance of an etiological approach in the first stage and pharmacological and non-pharmacological treatment in the chronic phase. There are five main clinical forms of chronic chagasic cardiomyopathy: indeterminate, arrhythymogenic (predominantly dromotropic and extrasystolic), with ventricular dysfunction, thromboembolic and mixed forms. There are several diagnostic tests at the different stages, however, the ECG is the method of choice in longitudinal population studies in endemic areas because it is simple, with a low cost and a good sensitivity. Microscopic examination or parasitological diagnosis in the acute phase or immunodiagnostic tests are used to confirm the disease. The antiarrhythmic drug amiodarone, the most frequently prescribed agent for symptomatic ventricular arrhythmia treatment of Chagas’ disease patients, has also recently been shown to have antifungal activity. Cardiac device implantation is very common, and chronic Chagas disease patients require pacemaker implantation at a younger age in contrast with patients with other cardiac pathologies. In summary, Chagas disease is a social disease, endemic in Latin America and shows different prevalence rates in Latin American countries.
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Keywords

Chagas’ disease; American trypanosomiasis; diagnosis; management

About this article
Title

Chagas disease: State-of-the-art of diagnosis and management

Journal

Cardiology Journal

Issue

Vol 15, No 6 (2008)

Pages

493-504

Published online

2008-09-22

Bibliographic record

Cardiol J 2008;15(6):493-504.

Keywords

Chagas’ disease
American trypanosomiasis
diagnosis
management

Authors

Sérgio Dubner
Edgardo Schapachnik
Andrés Ricardo Pérez Riera
Elina Valero

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