Chagas heart disease is becoming a worldwide health burden and represents a major cause of cardiovascular death in areas where it is endemic. Although rarely observed in Switzerland, increased awareness of the disease is important, particularly in times of global migration and mobility.
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Chagas heart disease is becoming a worldwide health burden and represents a major cause of cardiovascular death in areas where it is endemic. Although rarely observed in Switzerland, increased awareness of the disease is important, particularly in times of global migration and mobility. Chagas disease is caused by
Trypanosoma cruzi, which is transmitted by infected triotamine bugs. The spectrum of cardiac involvement is variable. It ranges from an acute cardiac infection to chronic myocardial fibrosis. Acute infection is often asymptomatic and resolves spontaneously in up to 90% of cases, but it may also lead to an indeterminate form of chronic Chagas disease with positivity for antibodies against
T. cruzi. Thirty to forty percent of patients with indeterminate Chagas disease have involvement of the heart (Chagas cardiomyopathy), oesophagus (megaoesophagus), colon (megacolon), or all of these organs. The chronic disease is diagnosed by compatible clinical presentation (cardiac, digestive or cardio-digestive), and detection of antibodies against
T. cruzi antigens at least in two different serological tests. The acute disease is treated with benznidazole or nifurtimox, which are strongly recommended for all cases of acute, congenital or reactivated infection, including in children. Drug treatment can be offered to adults up to 50 years of age without advanced Chagas heart disease. During pregnancy, in severe hepatic or renal insufficiency and in advanced Chagas heart disease, treatment is not recommended. The treatment options of these patients are limited to heart failure medication. The present article presents a patient with newly diagnosed Chagas cardiomyopathy, who was admitted to our hospital with symptoms of heart failure. We provide an overview of Chagas disease in the current literature.
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