Taleb Mohammed M
Department of Cardiology, Mercy St. Vincent Medical Center, Toledo, OH, USA.
Heart Views. 2017 Apr-Jun;18(2):54-57. doi: 10.4103/1995-705X.208675.
Chronic Chagas cardiomyopathy (CCC) is a late complication of Chagas disease with various manifestations including arrhythmia, heart failure, thromboembolism, and stroke. In a patient with symptoms of heart failure and left ventricular apical aneurysm unexplained by structural heart or coronary vascular abnormalities, CCC should be strongly considered and inquiry made about exposure status. Typical electrocardiographic findings of bundle branch block, complete heart blocks, and ventricular arrhythmia are helpful clues. A positive trypanosomal immunoglobulin G antibody is supportive. Initiation of stage appropriate guideline-recommended heart failure regimen is the goal with careful attention paid to prevention of sudden cardiac death from ventricular arrhythmias.
慢性恰加斯心肌病（CCC）是恰加斯病的晚期并发症，有多种表现，包括心律失常、心力衰竭、血栓栓塞和中风。对于有心力衰竭症状且左心室心尖部动脉瘤无法用结构性心脏病或冠状血管异常解释的患者，应高度怀疑CCC，并询问其接触史。典型的心电图表现如束支传导阻滞、完全性心脏传导阻滞和室性心律失常是有用的线索。锥虫免疫球蛋白G抗体阳性有支持作用。目标是启动符合相应阶段指南推荐的心力衰竭治疗方案，同时密切关注预防室性心律失常导致的心源性猝死。
