Complete Resolution of Electrocardiographic Changes Induced by Acute Chagas Myocarditis

Joseane Elza T M Rossette Do Valle Valle,Raimundo Barbosa Barros,Luiz Carlos De Abreu,Andrés Ricardo Pérez Riera,Rodrigo Daminello Raimundo

doi:10.5935/2359-4802.20190010

Abstract

Abstract We present a case of a female adolescent with severe acute Chagas myocarditis, acquired by oral transmission in an endemic area in the Brazilian western Amazon, who had electrocardiographic changes normalized after empirical treatment with the antiparasitic drug benznidazole combined with conventional treatment for severe heart failure.

Highlights

Chagas disease (CD) is a neglected parasitic infection caused by the protozoan Trypanosoma cruzi, which infects a wide range of triatomines and mammalian species, including man
Conventional treatment was started for severe heart failure with intravenous and oral administration of furosemide, carvedilol at increasing doses, spironolactone, and angiotensinconverting enzyme (ACE) inhibitors
Possible modes of transmission of CD include: feces of the infected vector deposited on the skin and/ or mucous membranes, while the vector sucks blood; transplacental vertical transmission which depends on maternal immune status, parasite strain and placental factors; lab accidents caused by violation of biosafety regulations; organ transplantation from an infected donor, oral transmission by ingestion of contaminated food, including açaí and sugarcane juice

Summary

Introduction

Chagas disease (CD) is a neglected parasitic infection caused by the protozoan Trypanosoma cruzi, which infects a wide range of triatomines and mammalian species, including man. Of CD treated with BZ and NFX had parasite persistence and progressive electrocardiographic changes, similar to untreated control patients.[4,5] The cardiac form of the disease starts with an acute dilated myocarditis, followed by myocardial remodeling, fibrosis, and arrhythmias. Conventional treatment was started for severe heart failure with intravenous and oral administration of furosemide, carvedilol at increasing doses, spironolactone, and angiotensinconverting enzyme (ACE) inhibitors. A concomitant transthoracic echocardiogram revealed normal cardiac chambers and normal left ventricular ejection fraction (63%). This significant response to BZ indicates that this drug can be effective in the treatment of the acute phase of Chagas myocarditis, but not the chronic phase.[4,5]

Findings

Discussion

Conclusion