A HIGHLY SUSPECTED CASE OF CHRONIC CHAGAS HEART-DISEASE DIAGNOSED IN JAPAN

A 50-year-old South American Indian woman, a native of Brazil and now a resident of Shiga Prefecture, was admitted to our hospital because o f dyspnea on exertion. We initially suspected dilated cardiomyopathy d ue to an enlarged and diffusely hypokinetic left ventricle (LV) on ech ocardiogram. Coronary arteriograms were normal, and histological exami nation of right ventricular endomyocardial biopsy specimens showed fin dings compatible with chronic myocarditis, Magnetic resonance imaging revealed localized thinning and a small apical aneurysm at the LV. Sin ce she had previously lived in a high-risk region for Chagas' disease, two immunological examinations for Trypanosoma cruzi were performed. The results of both tests were compatible with the disease. Recently, an increasing number of patients with Chagas' disease have been found in the United States among immigrants from South American countries, a nd the risk of transmission of the disease through contaminated blood transfusion is becoming a national problem. We report this case with r eference to the present state of the problem in the United States and the potential problems it presents in Japan because of the marked incr ease in the number of immigrants from the affected area.