title: The Epidemiology, Clinical Manifestations, and Management of Chagas Heart Disease.
abstract: Chagas disease results from infection by the protozoan parasite Trypanosoma cruzi and is endemic in Latin America. T cruzi is most commonly transmitted through the feces of an infected triatomine, but can also be congenital, via contaminated blood transfusion or through direct oral contact. In the acute phase, the disease can cause cardiac derangements such as myocarditis, conduction system abnormalities, and/or pericarditis. If left untreated, the disease advances to the chronic phase. Up to one-half of these patients will develop a cardiomyopathy, which can lead to cardiac failure and/or ventricular arrhythmias, both of which are major causes of mortality. Diagnosis is confirmed by serologic testing for specific immunoglobulin G antibodies. Initial treatment consists of the antiparasitic agents benznidazole and nifurtimox. The treatment of Chagas cardiac disease comprises standard medical therapy for heart failure and amiodarone for ventricular arrhythmias, with consideration for implantable cardioverter-defibrillator. Chagas disease causes the highest infectious burden of any parasitic disease in the Western Hemisphere, and increased awareness of this disease is essential to improve diagnosis, enhance management, and reduce spread.
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, University of California Davis Medical Center, Sacramento, California.
authors.forename: Lindsey H
authors.initials: LH
authors.lastname: Malik
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, University of California Davis Medical Center, Sacramento, California.
authors.forename: Gagan D
authors.initials: GD
authors.lastname: Singh
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, University of California Davis Medical Center, Sacramento, California.
authors.forename: Ezra A
authors.initials: EA
authors.lastname: Amsterdam
mesh_terms: D000977:Antiparasitic Agents / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002598:Chagas Cardiomyopathy / Q000175:diagnosis / Q000453:epidemiology / Q000469:parasitology / Q000628:therapy; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000295:instrumentation; D006801:Humans; D011237:Predictive Value of Tests; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000977:Antiparasitic Agents; D002317:Cardiovascular Agents