[Heart pathology of extracardiac origin (V). Recent advances in chagasic cardiomyopathy].
OBJECTIVE
Chronic Chagas' heart disease is an important public health problem in Latin America. Rural migration from endemic to nonendemic countries has aroused widespread interest (United States, Spain) because of the possibility of observing affected patients.


METHODS
Review of recent literature.


RESULTS
The diagnosis of Chagas' cardiomyopathy is based on the triad of epidemiological history, positive serology and the clinical Chagas' syndrome. About 75% of asymptomatic seropositive subjects had no or almost no heart damage but the disease could be transmitted by blood donation. The other 25% may develop arrhythmias, heart failure and/or embolisms. Specific parasiticidal drugs are mainly used in the acute phase.


CONCLUSIONS
In countries where Chagas' disease is infrequent, patients may be inadvertently diagnosed as having primary dilated or ischemic cardiomyopathy. Disease reactivation in immunodepressed patients due to AIDS, chemotherapy for cancer or for organ transplantation constitutes a formidable clinical challenge. Sanitary prophylactic measures are the strategies of choice.
Acquatella
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Centro de Investigaciones Chagas J.F. Torrealba, Hospital Universitario de Caracas y Centro Médico, Venezuela. hacquatella@true.net
D000208:Acute Disease; D000818:Animals; D015551:Autoimmunity; D014355:Chagas Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology / Q000469:parasitology; D002908:Chronic Disease; D006801:Humans; D007303:Insect Vectors; D011379:Prognosis
Patología del corazón de origen extracardíaco (V). Avances recientes en miocardiopatía chagásica.