Chagas Disease: Chronic Chagas Cardiomyopathy

Chagas disease (CD) is a tropical vector-borne infection caused by the protozoan parasite Trypanosoma cruzi (T. cruzi), also known as American Trypanosomiasis. It is considered endemic in all South and Central America and in this past decades its becoming a burden particularly in the United States and Europe due to human migration. The vast majority of patients during the acute phase are asymptomatic, while chronic symptomatic phase appears years later, with around 30% progressing toward detectable organ damage affecting mainly the cardiovascular and digestive systems. Chagas cardiomyopathy is the leading cause of nonischemic cardiomyopathy (NICM) in Latin America and affects around 30% of infected patients. The foremost characteristics are a diffuse myocarditis with focal fibrosis, mainly located in the apex and basal segments of the posterior and inferior wall, leading to a highly arrhythmogenic disease. Treatment can be etiologic during the parasitic infection, without and established efficacy during the advanced chronic symptomatic phase. Chronic Chagas cardiomyopathy treatment consists in guided medical therapy for non-ischemic cardiomyopathy, but more studies are imperative to improve clinical outcomes, some of them already in progress, and hopefully soon refine treatment and recommendations.

Automated summary

Chagas disease is a tropical vector-borne infection caused by the parasite Trypanosoma cruzi, endemic in South and Central America but increasingly becoming a burden in the United States and Europe due to human migration. Most patients are asymptomatic during the acute phase, with around 30% progressing to detectable organ damage mainly affecting the cardiovascular and digestive systems in the chronic symptomatic phase, which can lead to Chagas cardiomyopathy, a leading cause of nonischemic cardiomyopathy in Latin America. Treatment during the parasitic infection is possible, but efficacy during the advanced chronic symptomatic phase remains uncertain. Further studies are needed to improve clinical outcomes and refine treatment recommendations.