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World J Cardiol. Jul 26, 2012; 4(7): 234-239
Published online Jul 26, 2012. doi: 10.4330/wjc.v4.i7.234
Published online Jul 26, 2012. doi: 10.4330/wjc.v4.i7.234
Emerging and under-recognized Chagas cardiomyopathy in non-endemic countries
Joana Cortez, Evelise Ramos, Cristina Valente, António Vieira, Infectious Diseases Department, Coimbra’s Hospital Centre and University, 3041-801 Coimbra, Portugal
Rui Providência, António Leitão-Marques, Cardiology Department, Coimbra’s Hospital Centre and University, 3041-801 Coimbra, Portugal
Jorge Seixas, Hygiene and Tropical Medicine Institute, Universidade Nova de Lisboa, 1349-008 Lisbon, Portugal
Manuela Meruje, Pathology Department, Coimbra’s Hospital Centre and University, 3041-801 Coimbra, Portugal
Author contributions: Cortez J and Providência R were assistant physicians of the patient and wrote the first version of the manuscript; Seixas J and Meruje M provided important information on pathology data; Leitão-Marques A performed myocardial biopsy; Ramos E, Valente C and Vieira A, as well as the previous authors, critically revised this paper, providing comments in order to improve and write the final version of the manuscript; and all authors have read the last version of this manuscript and have agreed with its submission.
Correspondence to: Joana Cortez, MD, Infectious Diseases Department, Coimbra’s Hospital Centre and University, 3041-801 Coimbra, Portugal. joanacortezalves@gmail.com
Telephone: +351-239-800155 Fax: +351-239-800132
Received: February 11, 2012
Revised: May 15, 2012
Accepted: May 22, 2012
Published online: July 26, 2012
Revised: May 15, 2012
Accepted: May 22, 2012
Published online: July 26, 2012
Abstract
Due to recent population emigration movements, an epidemic of Chagas disease is currently menacing most developed countries. The authors report the case of a 53-year-old Brazilian woman living in Europe for the last 10 years who developed heart failure symptoms, having a previous symptomatic sinus node disease with a pacemaker implant at age of 40 years. The diagnosis was based on serology and myocardial biopsy and the patient was treated with nifurtimox. The authors emphasize the need of a high level of suspicion in patients with suggestive epidemiology and the need of populational screening of specific high risk groups. New treatment options are also discussed.
Keywords: Chagas disease; Chagas cardiomyopathy; Dysrhythmia; Emigration; Non-endemic countries; Benznidazole; Nifurtimox