Chronic Chagas' heart disease in children and adolescents: a clinicopathologic study

Chronic Chagas’ Heart Disease in the Elderly: A Clinicopathologic Study

“…The frequency of mild conges tive heart failure (usually expressed as dys- decreased heart ganglion cells AF = Atrial fibrillation; VPC = ventricular premature contractions; ApAN = apical aneurism; RBE = rosary bead-type epicarditis; LAH = left anterior hemiblock; PCD = pulmonary conus dilatation; RA = right atrium; CHF = congestive heart failure: RBBB = right bundle branch block. pnea after performing ordinary physical ac tivity) in middle-aged nonselected patients with Chagas' disease has been reported to be about 45%, but severe congestive heart fail ure is rare [10], Similarly, mild congestive heart failure is present in 50% of elderly patients with chronic Chagas' heart disease, but severe congestive heart failure is also rare in this population [7], In contrast, se vere congestive heart failure has been de tected in 45% of patients living in highly endemic areas [15], and in 50% of patients referred to our university hospital [16], We also found a higher rate (77%) of severe con gestive heart failure in children and adoles cents with chronic Chagas' heart disease [5]. Therefore, the frequency of severe conges tive heart failure among elderly patients liv ing in our endemic area (52%) is similar to that detected among middle-aged ones.…”

“…Sudden death occurs in 15% of middle-aged patients with Chagas' disease [17] and is the mode of death in 30% of autopsied cases [17,18], with similar frequencies among children and adolescents with chronic Chagas' heart dis ease [5], Ventricular fibrillation, frequently heralded by multiform or couplets of ven tricular premature contractions, and AV block leading to asystole are the mechanisms considered to be responsible for the occur rence of sudden death in chronic Chagas' heart disease [17]. In fact, in the present study, multiform ventricular premature con tractions, ventricular fibrillation and com plete AV block were detected in all patients who experienced sudden death.…”

“…This set of char acteristics was assumed to be important for the study, and maybe the understanding, of the pathogenesis of chronic Chagas' heart disease [5]. On the other hand, an extensive review of the literature failed to reveal a sim ilar study in elderly patients with chronic Chagas' heart disease except for two nondetailed reports [6,7], Therefore, the present study was undertaken as a first attempt to characterize chronic Chagas' heart disease in the elderly as well as to improve the knowl edge of the pathogenesis of this disease.…”

Weekly electrocardiographic pattern in mice infected with two different Trypanosoma cruzi strains

“…The parasite infective strain is a very important factor to determine the evolution of the cardiopathy [28]. The electrocardiographic abnormalities, with or without clinical symptoms, are the most frequent findings in this disease [29].…”

Electrocardiographic changes inT. cruzi-infected rats after the ajmaline test

“…Although chronic cardiopathy may occur in children and adolescents [9] there is general agreement that chronic Chagas' disease is manifested around the fourth decade of life [14]. Thus, a long time elapses between infection with T. cruzi and the clinical manifestations of the disease.…”