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Claudio L. Pereira da Cunha
Federal University of Parana, BrazilTitle: Chagas Heart Disease: The Evolution of the Disease and its Complementary Exams
Abstract
Chagas Disease (CD) is caused by Trypanosoma cruzi,
a protozoan parasite that can cause acute myocarditis as well as chronic
fibrosing myocarditis. CD is the most common cause of non-ischemic
cardiomyopathy in Latin America. The prevalence of CD is decreasing in Brazil. In 1984
it was 4% of population, and in 2020 estimates of the prevalence ranged from 1%
to 2%. Vector control strategies have led to a substantial decline in the
global prevalence of the disease, estimated at 18 million in 1990 and 6 million
in 2018. Despite the evident progress in the containment of new
cases of CD, the sick population is still very large. Laboratory techniques for
the diagnosis of chronic CD have not changed for years; indirect
immunofluorescence, hemagglutination and ELISA (enzyme immunoassay) tests are
used. Because of the possibility of false positives, it is recommended that at
least two of these methods are used. In the acute phase the preferred test is PCR. Cardiovascular assessment is essential to detect
cardiac damage. Electrocardiogram is a very important test in the initial
evaluation and can indicate whether there is established cardiomyopathy,
arrhythmias and contributes to the estimation of cardiovascular risk. Chest
radiography assess cardiac chambers and pulmonary congestion. Echocardiography
is the key test to identify structural and functional abnormalities, it
integrates routine investigation in the acute and chronic phases, regardless of
symptoms, even in the Indeterminate Form. Holter monitoring is another
fundamental test for diagnostic investigation, therapeutic management and
prognostic assessment of CD. Cardiovascular magnetic resonance is recommended
if echocardiography is suboptimal or nondiagnostic, and for evaluation of the
presence and extent of myocardial fibrosis. The evolution of the
disease is improving and complementary exams are very important in the
evaluation of CD patients
Biography
Claudio L. Pereira da Cunha graduated in Medical School at Federal
University of Parana, Brazil. He got a MS degree in the same University and a
PhD degree in the Federal University of Rio de Janeiro, Brazil. He was a
Research Fellow at Mayo Clinic, Rochester – MN, USA, working mostly in the
Echocardiography area. He was admitted as Assistant Professor in the Federal
University of Parana and later on was Full Professor and Head of Cardiology
Division. He has more than 80 publications and 300 conferences at meetings of
Cardiology. He had 40 investigators under his orientation to get MS and PhD
degrees. He has been serving as an editorial board member of two journals in
cardiovascular area.