Arq. Bras. Cardiol. 2019; 113(2): 286-293

Case 4/2019 – 26-Year-Old Man with Congenital Chagas Disease and Heart Transplantation

Henrique Trombini Pinesi , Tânia Mara Varejão Strabelli , Vera Demarchi Aiello

DOI: 10.5935/abc.20190162

Clinical aspects

Chagas’ disease was first described by Brazilian physician and scientist Carlos Chagas in 1909. This multifaceted disease is caused by the protozoan Trypanosoma cruzi, which can be transmitted in different ways. Vector transmission through hematophagous insects is the most classic one, although it has declined in importance in recent years with measures to control the vector population. Transfusion transmission, as well as vector transmission, have shown a drastic reduction in the last decades, and no cases have been reported in Brazil for years. In contrast, there was an increase in reports of oral transmission. This form of contagion was little known but gained importance, with several descriptions of micro-epidemic events in the country, especially related to the consumption of açai berry. The development of the acute phase of the disease is more common in the oral transmission. In the context of controlling the main forms of contagion, vertical transmission has become relevant.

The World Health Organization (WHO) estimates there are approximately 8 million individuals infected with Chagas disease worldwide, with an annual mortality of 10,000 people due to disease complications. Most of these cases are found in Latin America, and Brazil is the country with the majority of infected individuals (approximately 4.6 million individuals). The decrease in transmission was accompanied by a reduction in mortality, estimated in 2007 to be 2.78 deaths/year for every 10,000 inhabitants. Another change in the disease epidemiology in recent years has been the increase in cases in non-endemic regions, such as the USA and Europe, which has contributed to the increased attention given by the international scientific community to Chagas’ disease.

[…]