title: [Chronic chagasic cardiopathy in the Rio Negro, Amazon State. Report of three new autochthonous cases confirmed by serology, clinical examination, chest X-rays, electro and echocardiography].
abstract: We report three new autochthonous cases of chronic chagasic cardiomyopathy from Rio Negro, Amazon State, confirmed by serology (indirect immunofluorescence, ELISA and Western-blot for Trypanosoma cruzi infection), clinical examination, chest X-rays, electro- and echocardiography. The three patients were born and lived all their lives in the Rio Negro region working as piaçaba gatherers, where they were bitten several times by sylvatic triatomine bugs. The clinical feature was congestive heart failure and intraventricular conduction impairment in the three cases (right bundle branch block with left anterior hemiblock in two cases, left bundle branch block of 3rd degree in one), polymorphic ventricular extrasystoles in two cases and primary T wave inversion in another one. The echocardiographic evaluation showed a significant increasing of the left ventricular diameters with ejection fraction lesser than 36%, and myocardial segmental impairment pattern, including apical aneurysm and postero-inferior akinesia in the three patients. These are the first autochthonous cases of chronic Chagasic cardiomyopathy from the Brazilian Amazon state with echocardiographic pattern suggestive of Chagas' disease.
authors.affiliation: Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ.
authors.forename: Sérgio Salles
authors.initials: SS
authors.lastname: Xavier
authors.forename: Andréa Silvestre
authors.initials: AS
authors.lastname: Sousa
authors.forename: Pedro Albajar
authors.initials: PA
authors.lastname: Viñas
authors.forename: Angela C V
authors.initials: AC
authors.lastname: Junqueira
authors.forename: Márcio Neves
authors.initials: MN
authors.lastname: Bóia
authors.forename: José Rodrigues
authors.initials: JR
authors.lastname: Coura
mesh_terms: D000368:Aged; D001938:Brazil; D002598:Chagas Cardiomyopathy / Q000175:diagnosis* / Q000503:physiopathology; D002908:Chronic Disease; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged