The scientific construction of chronic Chagas heart disease (CCHD) started in
1910 when Carlos Chagas highlighted the presence of cardiac arrhythmia during
physical examination of patients with chronic Chagas disease, and described a
case of heart failure associated with myocardial inflammation and nests of
parasites at autopsy. He described sudden cardiac death associated with
arrhythmias in 1911, and its association with complete AV block detected by
Jacquet's polygraph as Chagas reported in 1912. Chagas showed the presence of
myocardial fibrosis underlying the clinical picture of CCHD in 1916, he
presented a full characterization of the clinical aspects of CCHD in 1922. In
1928, Chagas detected fibrosis of the conductive system, and pointed out the
presence of marked cardiomegaly at the chest X-Ray associated with minimal
symptomatology. The use of serological reaction to diagnose CCHD was put into
clinical practice in 1936, after Chagas' death, which along with the 12-lead
ECG, revealed the epidemiological importance of CCHD in 1945. In 1953, the long
period between initial infection and appearance of CCHD was established, whereas
the annual incidence of CCHD from patients with the indeterminate form of the
disease was established in 1956. The use of heart catheterization in 1965,
exercise stress testing in 1973, Holter monitoring in 1975, Electrophysiologic
testing in 1973, echocardiography in 1975, endomyocardial biopsy in 1981, and
Magnetic Resonance Imaging in 1995, added to the fundamental clinical aspects of
CCHD as described by Carlos Chagas.