Multimodality Imaging of Chagas Heart Disease: Review and Case Presentation

Abstract

Chagas disease (CD) is a neglected tropical disease (NTD) caused by Trypanosoma cruzi, a hemoflagellate protozoa. CD is diagnosed by epidemiologic history and two positive serological tests. The infection has two main clinical phases: acute, early after acquiring the infection, and chronic. The electrocardiogram (ECG) is the first tool to diagnose chronic Chagas heart disease after CD serological diagnosis. In addition, the different cardiac imaging modalities, including chest X-ray, echocardiography, single photon emission computed tomography (SPECT), computed tomography (CT), and magnetic resonance, play a crucial role in detecting the cardiac involvement, establishing the prognosis, stratifying patient risk, and addressing the management of CD patients. In this review of the current literature, we summarize the epidemiology, pathophysiology, and clinical presentation of CD. We also discuss the indications, advantages, and limitations of the different cardiac imaging modalities. We also present some case examples, where cardiac imaging proved helpful in cardiac CD (CCD). The early mortality and substantial disability caused by CD represents a health, social and economic burden, particularly in the Latin America. To harness the full potential of medical imaging for the effective management of patients with CD, a comprehensive approach is essential. This involves a concerted effort to invest in the education of medical providers and to facilitate widespread access to diagnostic tools. Accessible and timely diagnosis is crucial for initiating prompt and targeted interventions. Finally, continuous investment in research is vital to advance our understanding of CD and develop innovative solutions for improved patient care.