Chagas disease natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
About 30% of infected people who are not treated will develop chronic or symptomatic Chagas disease. It may take more than 20 years from the time of the original infection to develop heart or digestive problems. Abnormal heart rhythms (arrhythmias, ventricular tachycardia) may cause sudden death. Once heart failure develops, death usually occurs within several years.
Complications
Complications of Chagas disease include:
- Myocarditis
- Meningoencephalitis
- Congestive heart failure
- Apical aneurysm
- Thromboembolism
- Sudden death
- Esophagitis
- Esophageal cancer
- Fecaloma
- Volvulus of sigmoid colon
Prognosis
An index for classification of patients who have Chagas' disease was published in the August 24, 2006 edition of the New England Journal of Medicine.[1] Based on over 500 patients, this index includes clinical aspects, X-ray findings, EKG, echocardiography and Holter.
| Risk Factor | Points |
|---|---|
| NYHA class III or IV | 5 |
| Cardiomegaly | 5 |
| Wall motion abnormalities | 3 |
| Non-sustained ventricular tachycardia | 3 |
| Low voltage on ECG | 2 |
| Male gender | 2 |
| Total Points | Risk of death in 10 years |
|---|---|
| 0–6 | 10% |
| 7–11 | 40% |
| 12–20 | 85% |
References
- ↑ Rassi A Jr, Rassi A, Little W, Xavier S, Rassi S, Rassi A, Rassi G, Hasslocher-Moreno A, Sousa A, Scanavacca M (2006). "Development and validation of a risk score for predicting death in Chagas' heart disease". N Engl J Med. 355 (8): 799–808. PMID 16928995.