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| {{Chagas disease}} | | {{Chagas disease}} |
| | {{CMG}} |
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| | ==Overview== |
| | RBBB and AV block are common findings on ECG among patients with Chagas disease cardiomyopathy. |
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| | ==Electrocardiogram== |
| | *Annual 12-lead ECG is recommended for all (treated and untreated) patients with Chagas disease: |
| | *Abnormal 12-lead ECG warrant further cardiac evaluation: |
| | :*Echocardiography |
| | :*Ambulatory ECG evaluation |
| | :*Electrophysiological studies |
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| | ==Common ECG Findings== |
| | *RBBB |
| | *AV blocks |
| | *Tachyarrhythmias |
| | *Bradyarrhythmias |
| | *Sinus node dysfunction |
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| ==Overview==
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| The electrocardiogram can demonstrate [[q waves]] due to replacement of the [[myocardium]] by electrically inert tissue.
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| ===Electrocardiogram in acute Chagas disease===
| | '''Acute form of Chagas Disease''' |
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| Electrocardiogram during the acute phase of Chagas disease may demonstrate diffuse ST-T changes and low QRS voltage reflective of perimyocarditis. Other abnormalities include combined conduction disturbances, right bundle-branch block (RBBB), first-degree or second-degree atrioventricular block, and left anterior fascicular block (LAFB).<ref name="pmid9209939">{{cite journal | author = Parada H, Carrasco HA, Añez N, Fuenmayor C, Inglessis I | title = Cardiac involvement is a constant finding in acute Chagas' disease: a clinical, parasitological and histopathological study | journal = Int. J. Cardiol. | volume = 60 | issue = 1 | pages = 49–54 | year = 1997 | month = June | pmid = 9209939 | doi = | url = | issn = }}</ref><ref name="pmid11442212">{{cite journal | author = Carme B, Aune I, Nguyen G, Aznar C, Beaudet B | title = Four cases of acute chagasic myocarditis in French Guiana | journal = Am. J. Trop. Med. Hyg. | volume = 64 | issue = 3-4 | pages = 162–3 | year = 2001 | pmid = 11442212 | doi = | url = | issn = }}</ref> A normal electrocardiogram during the acute phase of Chagas disease suggests a favorable prognosis, since fewer than 15% of fatal cases were reported to have a normal tracing.<ref name="pmid2486527">{{cite journal | author = Dias JC | title = The indeterminate form of human chronic Chagas' disease A clinical epidemiological review | journal = Rev. Soc. Bras. Med. Trop. | volume = 22 | issue = 3 | pages = 147–56 | year = 1989 | pmid = 2486527 | doi = | url = | issn = }}</ref>
| | In a patient with diagnosed Chagas disease, cardiac damage is suspected if one or more following ECG findings occurs: |
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| ===Electrocardiogram in chronic Chagas disease===
| | * [[Right bundle-branch block]] ([[RBBB]]), |
| In a prospective study of chronic Chagas disease, the most common electrocardiographic alterations are RBBB and the combination of LAFB and RBBB, whereas left atrial enlargement, pathologic Q-wave, and left ventricular hypertrophy are significantly infrequent.<ref name="pmid16680295">{{cite journal | author = Braga JC, Reis F, Aras R, ''et al.'' | title = [Clinical and therapeutics aspects of heart failure due to Chagas disease] | language = Portuguese | journal = Arq. Bras. Cardiol. | volume = 86 | issue = 4 | pages = 297–302 | year = 2006 | month = April | pmid = 16680295 | doi = /S0066-782X2006000400010 | url = | issn = }}</ref> Patients with ventricular extrasystoles along with conduction defects have an increased risk for sudden death.<ref name="pmid14228098">{{cite journal | author = PORTO CC | title = [THE ELECTROCARDIOGRAM IN THE PROGNOSIS AND EVOLUTION OF CHAGAS' DISEASE] | language = Portuguese | journal = Arq. Bras. Cardiol. | volume = 17 | issue = | pages = 313–46 | year = 1964 | month = October | pmid = 14228098 | doi = | url = | issn = }}</ref> Intraventricular conduction abnormalities, sustained ventricular tachycardia, T-wave axis deviation, and QT-interval dispersion are predictors of mortality.<ref name="pmid16185616">{{cite journal | author = Viotti R, Vigliano C, Lococo B, ''et al.'' | title = [Clinical predictors of chronic chagasic myocarditis progression] | language = Spanish; Castilian | journal = Rev Esp Cardiol | volume = 58 | issue = 9 | pages = 1037–44 | year = 2005 | month = September | pmid = 16185616 | doi = | url = | issn = }}</ref><ref name="pmid15110206">{{cite journal | author = Salles GF, Xavier SS, Sousa AS, Hasslocher-Moreno A, Cardoso CR | title = T-wave axis deviation as an independent predictor of mortality in chronic Chagas' disease | journal = Am. J. Cardiol. | volume = 93 | issue = 9 | pages = 1136–40 | year = 2004 | month = May | pmid = 15110206 | doi = 10.1016/j.amjcard.2004.01.040 | url = | issn = }}</ref><ref name="pmid12835217">{{cite journal | author = Salles G, Xavier S, Sousa A, Hasslocher-Moreno A, Cardoso C | title = Prognostic value of QT interval parameters for mortality risk stratification in Chagas' disease: results of a long-term follow-up study | journal = Circulation | volume = 108 | issue = 3 | pages = 305–12 | year = 2003 | month = July | pmid = 12835217 | doi = 10.1161/01.CIR.0000079174.13444.9C | url = | issn = }}</ref><ref name="pmid12822748">{{cite journal | author = Salles GF, Cardoso CR, Xavier SS, Sousa AS, Hasslocher-Moreno A | title = Electrocardiographic ventricular repolarization parameters in chronic Chagas' disease as predictors of asymptomatic left ventricular systolic dysfunction | journal = Pacing Clin Electrophysiol | volume = 26 | issue = 6 | pages = 1326–35 | year = 2003 | month = June | pmid = 12822748 | doi = | url = | issn = }}</ref>
| | * [[Left anterior fascicular block]] ([[LAFB]]), |
| | * Atrio-Ventricular blocks |
| | * Multifocal [[PVC|PVCs]] |
| | *[[Sinus bradycardia]] |
| | *Abnormal ST segment and / or T wave changes |
| | *Abnormal T and / or Q waves |
| | *[[Myocarditis]] is infrequent, appearing in only 1-5% of patients whose having the acute phase of [[Chagas Disease]] (1-5 of every 10,000 infected subjects). <br /> |
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| ==References== | | ==References== |
| | {{Reflist|2}} |
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| | {{WH}} |
| | {{WS}} |
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| {{reflist|2}}
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| [[Category:Parasitic diseases]]
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| [[Category:Zoonoses]]
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| [[Category:Tropical disease]]
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| [[Category:Neglected diseases]]
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| [[Category:Insect-borne diseases]]
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| [[Category:Disease]] | | [[Category:Disease]] |
| | [[Category:Up-To-Date]] |
| | [[Category:Neurology]] |
| | [[Category:Emergency medicine]] |
| [[Category:Infectious disease]] | | [[Category:Infectious disease]] |
| [[Category:Mature chapter]] | | [[Category:Gastroenterology]] |
| [[Category:Needs content]] | | [[Category:Cardiology]] |
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| {{WH}}
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| {{WS}}
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