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Treatment and prognosis of Chagas heart disease

INTRODUCTION

Chagas disease (CD) is caused by Trypanosoma cruzi, a protozoan parasite that can cause acute myopericarditis as well as chronic fibrosing myocarditis. Chagas myocarditis is the most common cause of non-ischemic cardiomyopathy in Latin America [1].

The treatment and prognosis of Chagas heart disease will be reviewed here. Other issues related to CD, including clinical manifestations and diagnosis of Chagas heart disease and noncardiac manifestations, are discussed separately. (See "Clinical manifestations and diagnosis of Chagas heart disease" and "Chagas disease: Natural history and diagnosis" and "Pathology and pathogenesis of Chagas disease" and "Gastrointestinal Chagas disease" and "Antitrypanosomal drug therapy for Chagas disease" and "Chagas disease: Management of acute disease, early chronic disease, and disease in immunocompromised hosts".)

PROGNOSIS

Overview — The natural history of Chagas disease has been divided into acute and chronic phases. Cardiac involvement and prognosis in the acute phase of T. cruzi is discussed separately. (See "Clinical manifestations and diagnosis of Chagas heart disease" and "Chagas disease: Natural history and diagnosis".)

The indeterminate form of chronic T. cruzi has been defined as a phase of chronic T. cruzi infection in which anti-T. cruzi antibodies are present but no signs or symptoms of Chagas cardiomyopathy or gastrointestinal involvement are identified. Various criteria have been proposed to define the indeterminate form, as discussed separately. (See "Clinical manifestations and diagnosis of Chagas heart disease", section on 'Definition'.)

About one-third to one-half of patients with the indeterminate form develops cardiomyopathy after a latent period ranging from 5 to 30 years. Chronic Chagas disease cardiomyopathy (CCC) is a cause of heart failure, cardiac arrhythmias and thromboembolism.

                  

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Literature review current through: May 2013. | This topic last updated: Nov 20, 2012.
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