Chagas disease is a parasitic infection transmitted to humans primarily through bug' bite. This condition is endemic in Latin America and affects about 6–8 million people worldwide. However, due to migration,, it has become a health threat in non-endemic places such as Canada, USA, and Europe.
Initially, after being bitten by a bug,a patient may develop symptoms that can be confused with the flu and disappear spontaneously in 90% of the cases in around 60 days (acute phase). Following this, during one or two decades, the patients could be asymptomatic, meanwhile, the parasite is causing “silent damage”. Eventually, 30-40% of the asymptomatic patients will develop clinical manifestations in various organs such as the brain, gastrointestinal tract, and the heart which is most commonly affected in the chronic phase of the disease.
The heart condition (Chagas cardiomyopathy) is a serious condition resulting from inflammation and damage of the heart muscle developing heart failure and other serious complications such as stroke. The most common symptoms are fatigue, weakness, difficulty breathing, palpitations, chest pain, and fluid retention(edema) in the legs, ankles, or feet. Chagas cardiomyopathy has been associated with higher mortality and morbidity rates compared to other heart conditions.
Diagnosing involves a combination of clinical evaluation, laboratory tests (to detect the presence of the Trypanosoma cruzi antibodies or antigens in the blood), and other studies such as electrocardiogram, echocardiogram, and Cardiac Magnetic Resonance to identify any structural abnormalities. An integrative assessment is key to impacting the prognosis and quality of life given the early diagnosis and treatment are challenging as a non-widely recognized condition.
Primary care is focused on managing symptoms and slowing down progress including heart failure medications and lifestyle modifications because antiparasitic therapy may be used in the acute stage. In severe cases, it may require surgical intervention such as valve repair and even heart transplantation. Once the cardiomyopathy is detected regular follow-up is critical to check the condition and adjust treatment if it is needed. Another major point to keep in mind is prevention; differents strategies have been described to reduce exposure to triatomine bugs such as the use of insect repellents and sleeping under bed nets in areas where the bugs are prevalent.
Increasing awareness and improving recognition of Chagas disease is crucial for helping affected populations. Using novel techniques such as Cardiac Magnetic Resonance could help the physician recognize the patients in the early stages, give timely treatment and prevent complications. Our research team is working to find new markers in Cardiac Magnetic Resonance studies in order to increase knowledge about this often-overlooked disease.
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