Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2007;60:285-93 - Vol. 60 Num.03 DOI: 10.1016/S1885-5857(07)60153-4

Diagnosis, Management and Treatment of Chronic Chagas' Heart Disease in Areas Where Trypanosoma cruzi Infection Is Not Endemic

Joaquim Gascón a, Pedro Albajar b, Elías Cañas c, María Flores d, Jordi Gómez i Prat e, Ramón N Herrera f, Carlos A Lafuente g, Héctor L Luciardi f, Álvaro Moncayo h, Lluís Molina i, José Muñoz a, Sabino Puente j, Ginés Sanz k, Begoña Treviño e, Xavier Sergio-Salles l

a Secció Medicina Tropical-Centre Salut Internacional, IDIBAPS, Hospital Clínic, Barcelona, España,
b Departamento de Medicina Tropical, Instituto Oswaldo Cruz-Fiocruz, Río de Janeiro, Brasil,
c Consulta Salud Internacional, Hospital Universitario Virgen del Rocío, Sevilla, España,
d Servicio de Parasitología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, España,
e Unitat de Medicina Tropical i Salut Internacional Drassanes, ICS, Barcelona, España,
f Facultad de Medicina, Universidad Nacional de Tucumán, Tucumán, Argentina,
g Medicina Tropical, Hospital Japonés, Santa Cruz, Bolivia,
h Universidad de los Andes, Bogotá, Colombia,
i Servicio de Cardiología, Hospital del Mar, Barcelona, España,
j Sección de Medicina Tropical, Hospital Carlos III, Madrid, España,
k Centro Nacional de Investigaciones Cardiovasculares, Madrid, España,
l Fundaçao Oswaldo Cruz, IPEC, UFRJ, HUCFF, Río de Janeiro, Brasil,

Keywords

Chagas' disease. Heart disease. Arrhythmia. Sudden death.

Abstract

Chagas' disease, or American trypanosomiasis, is a parasitic zoonosis found only in the Americas. Under natural conditions, Trypanosoma cruzi is transmitted by insects belonging to different species of Triatoma. However, several routes of transmission that do not involve insect vectors have also been described, such as transmission via blood products or transplantation of infected organs, and vertical transmission. At present, the number of people infected with Chagas' disease worldwide is estimated to be about 10-12 million. The process of urbanization in Latin America and migratory population movements from endemic countries have led to the disease being diagnosed in non-endemic areas. It is estimated that 20-30% of individuals infected with T. cruzi will develop symptomatic heart disease at some point during their lives. The specific differential characteristics of chronic chagasic cardiopathy, lack of knowledge of the disease among many healthcare workers, and the fact that arrhythmia or sudden death is frequently the first manifestation of disease all make it essential that diagnostic and therapeutic protocols for the disease are developed and disseminated. The aim should be to improve patient care by increasing understanding of the condition by physicians and other healthcare professionals who may be involved in its detection and treatment.

1885-5857/© 2007 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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