[Chagas' disease and ischemic stroke].
American trypanosomiasis, known as Chagas' disease (CD) is a major Public Health problem in South America. Chronic cardiomyopathy is the most common clinical form of CD. Chagasic cardiomyopathy affects about 30 % of CD patients, and its manifestations begin on average 10-40 years after the initial infection. Chagas' cardiomyopathy is characterized by congestive heart failure, sudden cardiac death, intraventricular conduction defects, arrhythmias and thromboembolism. The relationship between Chagas' cardiomyopathy and ischemic stroke was reviewed. Significant variables that predict ischemic stroke in chagasic patients have been identified: apical aneurysm, cardiac insufficiency and cardiac arrhythmia. Prevalence of apical aneurysm in CD stroke patients has been estimated in 37%. The diagnosis of CD may be established after stroke presentation in at least 40% of patients. Chagasic cardiomyopathy should be included in the differential diagnosis of the etiology of stroke, being a potential source of cardioembolic stroke.
Carod-Artal
F J
FJ
Servicio de Neurologia, Hospital Sarah, Brasilia DF, Brazil. FJCarod@aol.com
D000818:Animals; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D002598:Chagas Cardiomyopathy / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D014355:Chagas Disease / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D002908:Chronic Disease; D006801:Humans; D007303:Insect Vectors; D012239:Rhodnius; D013020:South America; D020521:Stroke / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy