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Chagas cardiomyopathy

Key sources
The following summarized guidelines for the evaluation and management of chagas cardiomyopathy are prepared by our editorial team based on guidelines from the Pathway (Pathway 2023), the European Society of Cardiology (ESC 2022), the Brazilian Society of Cardiology (BSC/ASE 2018), the American Heart Association (AHA/HRS/ACC 2013), and the Brazilian Society of Cardiology (BSC 2011).
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Guidelines

1.Diagnostic investigations

Electrocardiogram
As per ASE 2018 guidelines:
Obtain an ECG in the initial evaluation to exclude conduction abnormalities (right bundle branch, left anterior fascicular, and AV block) and arrhythmias in all patients with newly diagnosed Chagas disease.
E
Consider obtaining follow-up ECGs at least every 2-5 years in patients with Chagas disease with the indeterminate form.
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  • Echocardiography

  • Advanced cardiac imaging

  • Chest radiography

2.Medical management

Management of heart failure: manage HF in patients with Chagas-related heart disease according to current published guidelines on HF.
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  • Management of ventricular arrhythmia

  • Anticoagulation therapy

3.Therapeutic procedures

Implantable cardioverter-defibrillator: as per ACC 2022 guidelines, consider placing an ICD in patients with Chagas cardiomyopathy and symptomatic ventricular tachycardia, if antiarrhythmic drugs (amiodarone and β-blockers) are ineffective or not tolerated.
C

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  • Catheter ablation