Chronic Chagas' heart disease in a Japanease-Brazilian traveler - A case report

A 57-year-old Japanese-Brazilian man, visiting Japan for only 9 days, was a dmitted to our hospital due to syncope and frequent ventricular premature b eats. He grew up in a rural area of Brazil and moved to Sao Paulo in 1959 w hen he was 20 years old. We suspected chronic Chagas' heart disease, ie., d ilated cardiomyopathy with apical ventricular aneurysm, right bundle branch block with left anterior fascicular block, and various arrhythmias includi ng supraventricular premature beats, ventricular premature beats and non-su stained ventricular tachycardia because he showed typical echo- and electro cardiographic features of the disease. Coronary arteriograms were normal, a nd left ventriculogram confirmed the existence of apical ventricular aneury sm. A left ventricle biopsy specimen showed hypertrophic cardiac muscle wit h mild fibrosis. The diagnosis of chronic Chagas' disease was finally confi rmed by the demonstration of Trypanosoma cruzi itself in the blood as well as Trypanosoma cruzi antibodies.