BACKGROUND: Chagas disease (CD), caused by Trypanosoma cruzi, affects 6-7 million people worldwide annually, primarily in Central and South America, and >300,000 people in the United States. CD consists of acute and chronic stages. Hallmarks of acute CD include fever, myalgia, diaphoresis, hepatosplenomegaly, and myocarditis. Symptoms of chronic CD include pathologic involvement of the heart, esophagus, and colon. Myocardial involvement is identifiable by electrocardiogram and cardiac magnetic resonance imaging showing inflammation and left ventricular wall functional abnormalities. CASE REPORTS: We present two cases of CD identified in a single hospital in the Southeastern United States. Case 1 presents a patient with symptoms of anginal chest pain and associated shortness of breath with myocardial involvement suggestive of ischemic infarction but normal coronary arteries. Case 2 describes a patient with no physical symptoms and echocardiogram with ejection fraction of 50% with posterolateral and anterolateral wall hypokinesis but normal coronary arteries. CONCLUSION: With a growing number of immigrants from Central and South America in the United States, it is imperative for clinicians to include CD as part of the differential diagnosis for patients presenting with heart disease who have a history of exposure to T. cruzi endemic areas.
BACKGROUND:Chagas disease (CD), caused by Trypanosoma cruzi, affects 6-7 million people worldwide annually, primarily in Central and South America, and >300,000 people in the United States. CD consists of acute and chronic stages. Hallmarks of acute CD include fever, myalgia, diaphoresis, hepatosplenomegaly, and myocarditis. Symptoms of chronic CD include pathologic involvement of the heart, esophagus, and colon. Myocardial involvement is identifiable by electrocardiogram and cardiac magnetic resonance imaging showing inflammation and left ventricular wall functional abnormalities. CASE REPORTS: We present two cases of CD identified in a single hospital in the Southeastern United States. Case 1 presents a patient with symptoms of anginal chest pain and associated shortness of breath with myocardial involvement suggestive of ischemic infarction but normal coronary arteries. Case 2 describes a patient with no physical symptoms and echocardiogram with ejection fraction of 50% with posterolateral and anterolateral wall hypokinesis but normal coronary arteries. CONCLUSION: With a growing number of immigrants from Central and South America in the United States, it is imperative for clinicians to include CD as part of the differential diagnosis for patients presenting with heart disease who have a history of exposure to T. cruzi endemic areas.
Entities:
Keywords:
Chagas cardiomyopathy; Chagas disease; New Orleans
Authors: Anis Rassi; Anis Rassi; William C Little; Sérgio S Xavier; Sérgio G Rassi; Alexandre G Rassi; Gustavo G Rassi; Alejandro Hasslocher-Moreno; Andrea S Sousa; Maurício I Scanavacca Journal: N Engl J Med Date: 2006-08-24 Impact factor: 91.245
Authors: Andre Talvani; Manoel O C Rocha; John Cogan; Param Maewal; James de Lemos; Antonio L P Ribeiro; Mauro M Teixeira Journal: Mem Inst Oswaldo Cruz Date: 2004-11-18 Impact factor: 2.743
Authors: Sergio Sosa-Estani; Miriam Rubi Gamboa-León; Jaime Del Cid-Lemus; Fernando Althabe; Jackeline Alger; Olivia Almendares; María L Cafferata; Jean-Philippe Chippaux; Eric Dumonteil; Luz Gibbons; Nicolás Padilla-Raygoza; Dominique Schneider; José M Belizán; Pierre Buekens Journal: Am J Trop Med Hyg Date: 2008-11 Impact factor: 2.345
Authors: J Antonio Marin-Neto; Anis Rassi; Alvaro Avezum; Antonio C Mattos; Anis Rassi; Carlos A Morillo; Sergio Sosa-Estani; Salim Yusuf Journal: Mem Inst Oswaldo Cruz Date: 2009-07 Impact factor: 2.743