RT-168
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Sudden death in Chagas' disease
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Iván Mendoza, Federico Moleiro,
Juan Marques, Julio Guerrero, Alvaro Matheus, Freddy Rodriguez, Ana Rodriguez, Iván
Mendoza Britto, Antonio Bayés de Luna*, Agustin Castellanos**.
Section of Cardiology, Tropical Medicine Institute, Central University of
Venezuela, Caracas, Venezuela, *Hospital Sant Pau, Barcelona, Spain, **Jackson Memorial
Hospital, University of Miami, Miami, USA
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Abstract
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American trypanosomiasis or Chagas' disease is an
important problem of public health affecting 20 million people in Latin America. It is
caused by the flagellate parasite Trypanosoma cruzi. Chronic progressive heart disease
develop in approximately 20 to 40% of infected persons. Chagas' heart disease is one of
the leading causes of sudden death after coronary heart disease. Approximately, half of
the patients with Chagas' heart disease died suddenly. The mechanism of sudden death in
Chagas' disease include ventricular fibrillation or tachycardia, severe bradyarrhythmia,
embolic complication and spontaneous ventricular rupture. Proarrhythmia is common due to
the coexistence of heart failure and multiple electrophysiologic abnormalities including
sinus node dysfunction, intraventricular and atrioventricular conduction abnormalities,
severe multiform ventricular arrhythmia, abnormal Q waves and altered ST segment and T
wave abnormalities. Thus the ventricular arrhythmias of Chagas' heart disease are one of
the most demanding models on which an antiarrhythmic drug can be tested. Chagas' heart
disease is now a widen problem as a result of immigration. The transmission of Chagas'
disease via blood transfusion is not confined to countries where the disease is endemic.
The migration of persons infected by Trypanosoma cruzi poses a public health problem even
for countries where the disease is not transmitted by vector. Most of the Latin American
immigrant with Chagas' heart disease living in United States and Europe are either
undiagnosed or misdiagnosed as having either idiopathic cardiomyopathy or coronary artery
disease.
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Key Words
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Sudden Death
Chagas´heart disease, public health problem, insect vector, blood transfusion, congenital
form, dilated cardiomyopathy, ventricular arrhythmias, bradyarrhythmias, heart failure,
embolismus, proarrhythmia, amiodarone, R
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