Claudio L. Pereira da CunhaFederal University of Parana, Brazil
Title: Chagas Heart Disease: The Evolution of the Disease and its Complementary Exams
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
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.