Chagas heart disease: An overview of diagnosis, manifestations, treatment, and care

Table 1 Kuschnir classification (1985)[27]

Classification	ECG	X-ray / cardiac symptoms
0	Normal ECG findings	Normal heart size (on chest X-ray)
I	Abnormal ECG findings	Normal heart size (on chest X-ray)
II		Left ventricular enlargement
III		Congestive heart failure

ECG: Electrocardiogram.

Table 2 Brazilian consensus classification[9]

Classification	ECG	Echocardiogram	HF
A	Abnormal	No LV wall motion abnormalities	No
B1	Abnormal	LV wall motion abnormalities with LV ejection fraction (LVEF) ≥ 45%	No
B2	Abnormal	LV wall motion abnormalities with LVEF <45%	No
C	Abnormal	LV wall motion abnormalities	Compensated HF
D	Abnormal	LV wall motion abnormalities	Refractory HF

ECG: Electrocardiogram; HF: Heart failure; LV: Left ventricular.

Table 3 Modified Los Andes classification[28]

Classification	ECG	Echocardiogram	HF
IA	Normal	Normal	No
IB	Normal	Abnormal	No
II	Abnormal	Abnormal	No
III	Abnormal	Abnormal	Yes

ECG: Electrocardiogram; HF: Heart failure.

Table 4 I Latin American guidelines[12]

Classification	ECG /X-ray	Echocardiogram	HF
A	No structural heart disease (normal ECG and chest X-ray)	_	No
B1	ECG changes (arrhythmias or conduction disorders)	Mild contractile abnormalities with normal LVEF	No
B2		Decreased LVEF	No
C		Decreased LVEF	Prior or current symptoms of HF
D			Symptoms of HF at rest, refractory to maximized medical therapy (NYHA functional class IV).

ECG: Electrocardiogram; HF: Heart failure; LVEF: Left ventricular ejection fraction; NYHA: New York Heart Association.

Table 5 American Heart Association Statement[1]

Classification	ECG/ Echocardiogram	HF	Digestive changes
A (Indeterminate form - patients at risk for developing HF)	Normal ECG	Neither structural cardiomyopathy or HF symptoms	No
B1	Structural cardiomyopathy evidenced by ECG or echocardiographic changes with normal LVEF	Neither current or previous signs and symptoms of HF
B2	Structural cardiomyopathy characterized by decreased LVEF	Neither current or previous signs and symptoms of HF
C	LV systolic dysfunction	Current or previous symptoms of HF (NYHA functional class I, II, III, or IV)
D		Refractory symptoms of HF at rest despite optimized clinical treatment requiring specialized interventions.

ECG: Electrocardiogram; HF: Heart failure; LVEF: Left ventricular ejection fraction; NYHA: New York Heart Association.