Chagas disease electrocardiogram

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Template:GCC

Overview

The electrocardiogram can demonstrate q waves due to replacement of the myocardium by electrically inert tissue.

Electrocardiogram in acute Chagas disease

Myocardial involvement is a dominant feature in the acute phase of Chagas disease, as reflected by diffuse ST-T changes or low QRS voltage on the electrocardiogram. Other abnormalities include right bundle-branch block (RBBB), left anterior fascicular block (LAFB), combined conduction disturbances, and first-degree or second-degree atrioventricular block.[1][2][3] 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.[4]

Electrocardiogram in chronic Chagas disease

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.[5] Patients with ventricular extrasystoles along with conduction defects have an increased risk for sudden death.[6] Intraventricular conduction abnormalities, sustained ventricular tachycardia, T-wave axis deviation, and QT-interval dispersion are predictors of mortality.[7][8][9][10]

References

  1. Parada H, Carrasco HA, Añez N, Fuenmayor C, Inglessis I (1997). "Cardiac involvement is a constant finding in acute Chagas' disease: a clinical, parasitological and histopathological study". Int. J. Cardiol. 60 (1): 49–54. PMID 9209939. Unknown parameter |month= ignored (help)
  2. Carme B, Aune I, Nguyen G, Aznar C, Beaudet B (2001). "Four cases of acute chagasic myocarditis in French Guiana". Am. J. Trop. Med. Hyg. 64 (3–4): 162–3. PMID 11442212.
  3. ROSENBAUM MB (1964). "CHAGASIC MYOCARDIOPATHY". Prog Cardiovasc Dis. 7: 199–225. PMID 14223289. Unknown parameter |month= ignored (help)
  4. Dias JC (1989). "The indeterminate form of human chronic Chagas' disease A clinical epidemiological review". Rev. Soc. Bras. Med. Trop. 22 (3): 147–56. PMID 2486527.
  5. Braga JC, Reis F, Aras R; et al. (2006). "[Clinical and therapeutics aspects of heart failure due to Chagas disease]". Arq. Bras. Cardiol. (in Portuguese). 86 (4): 297–302. doi:/S0066-782X2006000400010 Check |doi= value (help). PMID 16680295. Unknown parameter |month= ignored (help)
  6. PORTO CC (1964). "[THE ELECTROCARDIOGRAM IN THE PROGNOSIS AND EVOLUTION OF CHAGAS' DISEASE]". Arq. Bras. Cardiol. (in Portuguese). 17: 313–46. PMID 14228098. Unknown parameter |month= ignored (help)
  7. Viotti R, Vigliano C, Lococo B; et al. (2005). "[Clinical predictors of chronic chagasic myocarditis progression]". Rev Esp Cardiol (in Spanish; Castilian). 58 (9): 1037–44. PMID 16185616. Unknown parameter |month= ignored (help)
  8. Salles GF, Xavier SS, Sousa AS, Hasslocher-Moreno A, Cardoso CR (2004). "T-wave axis deviation as an independent predictor of mortality in chronic Chagas' disease". Am. J. Cardiol. 93 (9): 1136–40. doi:10.1016/j.amjcard.2004.01.040. PMID 15110206. Unknown parameter |month= ignored (help)
  9. Salles G, Xavier S, Sousa A, Hasslocher-Moreno A, Cardoso C (2003). "Prognostic value of QT interval parameters for mortality risk stratification in Chagas' disease: results of a long-term follow-up study". Circulation. 108 (3): 305–12. doi:10.1161/01.CIR.0000079174.13444.9C. PMID 12835217. Unknown parameter |month= ignored (help)
  10. Salles GF, Cardoso CR, Xavier SS, Sousa AS, Hasslocher-Moreno A (2003). "Electrocardiographic ventricular repolarization parameters in chronic Chagas' disease as predictors of asymptomatic left ventricular systolic dysfunction". Pacing Clin Electrophysiol. 26 (6): 1326–35. PMID 12822748. Unknown parameter |month= ignored (help)

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