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Chagas cardiomyopathy

Guidelines

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 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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Diagnostic investigations

ECG
As per ASE/BSC 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.
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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

Medical management

Management of HF: as per Pathway 2024 guidelines, manage HF in patients with Chagas-related heart disease according to current published guidelines on HF.
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More topics in this section

  • Management of ventricular arrhythmia

  • Anticoagulation therapy

Therapeutic procedures

ICD: as per ESC 2022 guidelines, consider placing an ICD in patients with Chagas cardiomyopathy and symptomatic VT, if antiarrhythmic drugs (amiodarone and β-blockers) are ineffective or not tolerated.
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More topics in this section

  • Catheter ablation