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AN INFECTIOUS SOURCE OF CARDIOMYOPATHY AND SUDDEN DEATH: CHAGAS DISEASE
1204 JACC April 5, 2016 Volume 67, Issue 13
FIT Clinical Decision Making AN INFECTIOUS SOURCE OF CARDIOMYOPATHY AND SUDDEN DEATH: CHAGAS DISEASE Poster Contributions Poster Area, South Hall A1 Sunday, April 03, 2016, 3:45 p.m.-4:30 p.m. Session Title: FIT Clinical Decision Making: Non-Invasive Imaging and Valvular Heart Disease Abstract Category: Heart Failure and Cardiomyopathies Presentation Number: 1232-300 Authors: Josh Ford Grant, Laura Ronin, Neeraj Jain, Lousiana State University, New Orleans, LA, USA
Background: Delineating the etiology of cardiomyopathy is an important part of the workup upon initial diagnosis. We describe the case of a 30 year old previously healthy male presenting with VF arrest and dilated cardiomyopathy. Case: A 30 year old Hispanic Male with no prior past medical history presented to our hospital post-resuscitation for ventricular fibrillation (VF). Initial and subsequent EKGs were significant only for low QRS voltage. Echocardiogram was significant for LV EF <20% with global hypokinesis and left ventricular internal diameter in diastole (LVIDd) of 70 mm. A non-invasive evaluation for coronary disease was performed with cardiac CT angiography showing no atherosclerosis and normal origins of both left and right coronary artery ostia. The measured LVIDd was 76 mm. Evaluation of renal function, creatinine-kinase, hepatic function, iron studies, HIV, TSH, and urine toxicology were all unremarkable.
Decision Making: A profoundly dilated cardiomyopathy and ventricular arrhythmia in a young and otherwise healthy patient from South America raised the suspicion for Chagas cardiomyopathy. Screening for Trypanazoma cruzi was performed using a serologic test revealing elevated IgG titers. Medications for heart failure were initiated and a cardiac defibrillator was implanted for secondary prevention. Subsequent confirmatory enzyme immunoassay performed at the Centers for Disease was positive. Conclusions: Although uncommon, changes in epidemiology will undoubtedly result in a greater incidence and prevalence of Chagas cardiomyopathy. This case demonstrates the necessity for a high index of suspicion to diagnose Chagas cardiomyopathy.
FIT Clinical Decision Making AN INFECTIOUS SOURCE OF CARDIOMYOPATHY AND SUDDEN DEATH: CHAGAS DISEASE Poster Contributions Poster Area, South Hall A1 Sunday, April 03, 2016, 3:45 p.m.-4:30 p.m. Session Title: FIT Clinical Decision Making: Non-Invasive Imaging and Valvular Heart Disease Abstract Category: Heart Failure and Cardiomyopathies Presentation Number: 1232-300 Authors: Josh Ford Grant, Laura Ronin, Neeraj Jain, Lousiana State University, New Orleans, LA, USA
Background: Delineating the etiology of cardiomyopathy is an important part of the workup upon initial diagnosis. We describe the case of a 30 year old previously healthy male presenting with VF arrest and dilated cardiomyopathy. Case: A 30 year old Hispanic Male with no prior past medical history presented to our hospital post-resuscitation for ventricular fibrillation (VF). Initial and subsequent EKGs were significant only for low QRS voltage. Echocardiogram was significant for LV EF <20% with global hypokinesis and left ventricular internal diameter in diastole (LVIDd) of 70 mm. A non-invasive evaluation for coronary disease was performed with cardiac CT angiography showing no atherosclerosis and normal origins of both left and right coronary artery ostia. The measured LVIDd was 76 mm. Evaluation of renal function, creatinine-kinase, hepatic function, iron studies, HIV, TSH, and urine toxicology were all unremarkable.
Decision Making: A profoundly dilated cardiomyopathy and ventricular arrhythmia in a young and otherwise healthy patient from South America raised the suspicion for Chagas cardiomyopathy. Screening for Trypanazoma cruzi was performed using a serologic test revealing elevated IgG titers. Medications for heart failure were initiated and a cardiac defibrillator was implanted for secondary prevention. Subsequent confirmatory enzyme immunoassay performed at the Centers for Disease was positive. Conclusions: Although uncommon, changes in epidemiology will undoubtedly result in a greater incidence and prevalence of Chagas cardiomyopathy. This case demonstrates the necessity for a high index of suspicion to diagnose Chagas cardiomyopathy.