CARDIAC INVOLVEMENT IS A CONSTANT FINDING IN ACUTE CHAGAS-DISEASE - ACLINICAL, PARASITOLOGICAL AND HISTOPATHOLOGICAL STUDY

During the last 8 years 58 acute cases of Chagas' disease were studied . Patients from an endemic area of the state of Barinas, Venezuela, sh owed fever (98%) and circulating forms of T. cruzi (100%), and were tr eated with oral benznidazole. The recorded mortality was 8.6%. Acute m yocarditis was constantly found either in myocardial biopsies or at ne cropsy, even in patients without any other sign of cardiac compromise (36%), which was detected by chest X-ray in 58%, by 2D echocardiograph y in 52%, by resting ECG in 41% and by clinical findings in 27.5% of t he patients. Cardiomegaly was due to pericardial effusion rather than ventricular dilatation in most instances. Treatment eliminated parasit emia but negativized serology in only 20% of patients. It also appeare d to have little influence on the ongoing myocarditic process, emphasi zing the need for better therapeutic schedules, able to avoid or contr ol the early appearance of immunologic mechanisms and microcirculatory damage involved in the future development of chronic chagasic myocard itis. (C) 1997 Elsevier Science Inland Ltd.