Clinical aspects of the Chagasʹ heart disease

Chagasʹ heart disease, caused by protozoan Trypanosoma cruzi, is a common cause of cardiomyopathy in the Americas. Transmission of T. cruzi occurs through Reduviids, the kissing bugs. Less common ways of transmission are blood transfusion, congenital transmission, organ transplantation, laboratory accident, breastfeeding, and oral contamination. Infestation results in cardiac dysautonomia, myocardial apoptosis, and myocardial fibrosis. In acute phase, death is mostly caused by myocarditis and in chronic phase, it is mostly by irreversible cardiomyopathy. A majority of the patients with Chagasʹ disease remain in the latent phase of disease for 10 to 30 years or even for life. Specific anti-Chagasʹ therapy with trypanocide drugs is useful in acute phase but the management of chronic Chagasʹ heart disease is mostly empirical. The mortality during the acute phase of cardiac Chagas is around 5%. Five-year mortality of chronic Chagasʹ disease with cardiac dysfunction is above 50%. The clinical aspects of the Chagasʹ heart disease are concisely reviewed.