1/13. Four cases of acute chagasic myocarditis in french guiana.The authors report four cases of acute chagasic myocarditis which had been diagnosed and treated in Cayenne, french guiana, in the past 6 years. This French territory, which has the highest standard of living in south america, should be considered an area of risk for sporadic chagas disease with epidemiologic features similar to those of the disease found in dense Amazon forest areas. Appropriate measures must be taken to screen and promptly manage chagas disease in the french guiana population.- - - - - - - - - - ranking = 1keywords = myocarditis (Clic here for more details about this article) |
2/13. Analysis of the presence of trypanosoma cruzi in the heart tissue of three patients with chronic Chagas' heart disease.It is still unclear to what extent myocarditis-associated, chronic Chagas' heart disease is due to persisting trypanosoma cruzi. In the present study, we have analyzed tissue samples from the hearts of three patients with this disease. in situ hybridization provided little evidence for the presence of intact T. cruzi even at sites of strong inflammation. Nevertheless, micromanipulation techniques detected remnants of both T. cruzi kinetoplast dna and nuclear dna. trypanosoma cruzi dna was also detected in single macrophages dissected directly from frozen heart tissue sections. Thus, this analysis demonstrates that T. cruzi kinetoplast dna and nuclear dna are widely dispersed in the heart tissue, although in low amounts. Since we rarely detected intact T. cruzi parasites during the chronic phase of Chagas' heart disease, we can exclude heart tissue as a major parasite reservoir.- - - - - - - - - - ranking = 0.2keywords = myocarditis (Clic here for more details about this article) |
3/13. Emerging acute chagas disease in Amazonian brazil: case reports with serious cardiac involvement.Four cases of serious cardiac attacks by autochthonous trypanosoma cruzi infection from the Brazilian Amazon are reported; three of them occurred in micro-epidemic episodes. The manifestations included sudden fever, myalgia, dyspnea and signs of heart failure. Diagnosis was confirmed by specific exams, especially QBC (Quantitative Buffy Coat) and natural xenodiagnosis. Despite treatment with benznidazol, three patients died with serious myocarditis, renal failure and cardiac tamponade. The authors call attention to the emergence of this disease and reveal a previously unknown pathogenicity of T. cruzi strains in this area, added to a non-usual transmission form.- - - - - - - - - - ranking = 0.2keywords = myocarditis (Clic here for more details about this article) |
4/13. Chagas myocarditis and syncope.This case report describes the diagnosis of Chagas myocarditis in a patient from honduras who presented with syncope. The discussion summarizes the pathophysiology of cardiac chagas disease. Acute, latent, and chronic Chagas myocarditis are described. The role of CMR in diagnosing Chagas myocarditis is discussed.- - - - - - - - - - ranking = 1.4keywords = myocarditis (Clic here for more details about this article) |
5/13. Transcoronary chemical ablation of ventricular tachycardia in chronic chagasic myocarditis.OBJECTIVE. A case of incessant ventricular tachycardia in a patient with Chagas' disease that was successfully terminated by chemical ablation is reported. BACKGROUND. Chagas' disease is a common medical problem in south america. Ventricular tachyarrhythmias, atrioventricular conduction disturbances, congestive heart failure and sudden cardiac death are important manifestations of this disease. methods. Selective catheterization of the coronary artery supplying the arrhythmogenic area was performed by using a conventional angioplasty system and the arrhythmogenic area was ablated by injection of 96% sterile ethanol. RESULTS. ethanol (96%) injection initially in a lateral branch of the left circumflex artery and 2 days later in the proximal segment of the artery resulted in termination of ventricular tachycardia. Two weeks after ablation, programmed ventricular stimulation failed to induce ventricular tachycardia. CONCLUSION. Transcoronary chemical ablation should be considered in selected cases of Chagas' disease with incessant ventricular tachycardia.- - - - - - - - - - ranking = 0.8keywords = myocarditis (Clic here for more details about this article) |
6/13. Reactivation of Chagas' myocarditis during therapy of Hodgkin's disease.A 46-year-old female patient with chronic Chagas' myocarditis without heart failure was submitted to chemotherapy because of Hodgkin's disease. During treatment the frequency of polymorphic ventricular extrasystoles raised and the patient died by a sudden cardiac arrest. autopsy revealed chronic Chagas myocarditis with an acute exacerbation. Nests of amastygotes with a density of up to 14 pseudocysts/cm2 were found in the myocardium, although restricted to the septum and left ventricular posterolateral wall. Extensive histologic examination did not reveal parasites in other locations. This favors the concept of a localized exacerbation of Chagas' disease due to immunosuppression developing from a persistent parasitic focus in the heart. Although this reactivation during chemotherapy of malignant disease is rarely reported in literature, a careful monitoring of patients with positive Chagas' serology during chemotherapy is recommended.- - - - - - - - - - ranking = 1.2keywords = myocarditis (Clic here for more details about this article) |
7/13. Alternate Wenckebach conduction through the right bundle branch.This case report describes a patient with chronic chagasic myocarditis who presented with a unique tachycardia-dependent or phase 3 aberrant ventricular conduction. The electrocardiogram showed sinus tachycardia with sequences of alternate and progressive right bundle branch block, that is, Wenckebach periods of alternate beats. We postulated the existence of functional longitudinal dissociation in atrioventricular conduction axis, responsible for the alternant normal and Wenckebach beats.- - - - - - - - - - ranking = 0.2keywords = myocarditis (Clic here for more details about this article) |
8/13. Severe myocarditis and esophagitis during reversible long standing Chagas' disease recrudescence in immunocompromised host.An unusual form of reagudization of Chagas' disease, from its indeterminate phase, was documented in an immunocompromised patient. Long-standing progressive visceral aggression due to extensive intracellular proliferation of T. cruzi manifested by severe isolated right ventricular failure and esophageal ulcerations. Antiparasite chemotherapy was effective in the control of the disease.- - - - - - - - - - ranking = 0.8keywords = myocarditis (Clic here for more details about this article) |
9/13. A highly suspected case of chronic Chagas' heart disease diagnosed in japan.A 50-year-old South American Indian woman, a native of brazil and now a resident of Shiga Prefecture, was admitted to our hospital because of dyspnea on exertion. We initially suspected dilated cardiomyopathy due to an enlarged and diffusely hypokinetic left ventricle (LV) on echocardiogram. Coronary arteriograms were normal, and histological examination of right ventricular endomyocardial biopsy specimens showed findings compatible with chronic myocarditis. magnetic resonance imaging revealed localized thinning and a small apical aneurysm at the LV. Since she had previously lived in a high-risk region for Chagas' disease, two immunological examinations for trypanosoma cruzi were performed. The results of both tests were compatible with the disease. Recently, an increasing number of patients with Chagas' disease have been found in the united states among immigrants from South American countries, and the risk of transmission of the disease through contaminated blood transfusion is becoming a national problem. We report this case with reference to the present state of the problem in the united states and the potential problems it presents in japan because of the marked increase in the number of immigrants from the affected area.- - - - - - - - - - ranking = 0.2keywords = myocarditis (Clic here for more details about this article) |
10/13. pathology of patients with Chagas' disease and acquired immunodeficiency syndrome.The main pathologic findings in 23 patients with acquired immunodeficiency syndrome (AIDS) and Chagas' disease are reviewed; five are from our own experience and 18 from the literature. The presence of trypanosoma cruzi parasites and/or T. cruzi antibodies in blood and cerebrospinal fluid was recorded and computerized tomograms of the brain were evaluated. Twenty (87%) of the 23 subjects developed severe, multifocal or diffuse meningoencephalitis with necrosis and hemorrhage associated with numerous tissue parasites. The second most severely affected site was the heart. Seven (30.4%) of the 23 cases had myocarditis on pathologic examination. It was acute in four patients, chronic in two, and simultaneously acute and chronic in one. Acute myocarditis and meningoencephalitis are interpreted as being caused by relapses of chronic T. cruzi infections. An AIDS permissive role is suggested for these conditions since immunologic defense against T. cruzi is mediated mainly by T lymphocytes, whose CD4 subpopulation is depleted in patients with this disease. Consequently, AIDS is a factor that may favor the reactivation of T. cruzi infections. The lesions reported in the association of Chagas' disease with AIDS were compared with those reported from patients without AIDS having fatal, acute, vector-transmitted infections, contaminated blood transfusions, or accidental exposures in the laboratory. For the latter three, meningoencephalitis is uncommon. Only immunosuppressed cases of Chagas' disease have been described as having a pseudotumoral presentation that shows expanding lesions with a mass effect in the cranial cavity that causes intracranial hypertension and simulates neoplasms (tumors such as gliomas, lymphomas, metastases, etc.).- - - - - - - - - - ranking = 0.4keywords = myocarditis (Clic here for more details about this article) |
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