What is the pathology of Chagas disease?
Chagas disease is a chronic infection in which an acute phase with detectable circulating parasitaemia is followed by a lifelong chronic phase which can manifest as a variety of debilitating diseases. T. cruzi is usually transmitted when an infected reduvid vector bites the host and defaecates adjacent to the bite.
What does Chagas disease do to the heart?
Chagas cardiomyopathy represents the most frequent and serious complication of chronic Chagas disease, affecting about 20-30% of patients, potentially leading to heart failure, arrhythmias, thromboembolism, stroke and sudden death.
How does infection with T. cruzi lead to heart disease?
cruzi or immune effector cells directly, or could result from effects of the inflammatory infiltrate. T. cruzi induce production of the potent vasoconstrictor endothelin-1 from infected endothelial cells which may aggravate myocardial ischemia due to decreased circulatory capacity .
How does Chagas disease cause dilated cardiomyopathy?
The pathology of Chagas disease is based in an inmunoinflammatory reaction producing fibrosis and remodelling, mainly in the myocardium. In many cases these mechanisms result in a dilated cardiomyopathy with HF and reduced ejection fraction, frequent cardiac arrhythmias and different types of heart block.
Is Chagas an autoimmune disease?
Although questions regarding the functional role of autoimmunity in the pathogenesis of Chagas disease remain unanswered, the development of autoimmune responses during infection clearly occurs in some individuals, and the implications that this autoimmunity may be pathogenic are significant.
What parasite causes Chagas disease?
Chagas disease is caused by the parasite Trypanosoma cruzi, which is transmitted to animals and people by insect vectors that are found only in the Americas (mainly, in rural areas of Latin America where poverty is widespread).
Does Chagas disease cause myocarditis?
Chagas disease (CD) is caused by Trypanosoma cruzi, a protozoan parasite that can cause acute myopericarditis as well as chronic fibrosing myocarditis.
Does Chagas cause an enlarged heart?
Pathological features of chronic Chagas heart disease are distinct. On autopsy, there is typically cardiomegaly and increased cardiac mass, thinning of the ventricular walls, and aneurysmal lesions in various regions of the LV and right ventricle (RV).
What is hypersensitivity myocarditis?
Hypersensitivity myocarditis is an inflammatory disease of the myocardium usually related to a drug allergy. The clinical manifestations may be nonspecific, and the diagnosis is seldom suspected or established during life.
What organs does Chagas disease affect?
The heart is the most commonly affected organ in persons with chronic Chagas disease. Autopsy may reveal marked bilateral ventricular enlargement, often involving the right side more than the left, in the heart of patients who die of chagasic heart failure (see image below).