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Memorias del Instituto de Investigaciones en Ciencias de la Salud
On-line version ISSN 1812-9528
Abstract
ARRUA TORREANI, NR. Chagasic cardiopathy. Mem. Inst. Investig. Cienc. Salud [online]. 2013, vol.11, n.2, pp.65-77. ISSN 1812-9528.
The indeterminate phase of Chagas disease is a nomenclature that tends to disappear after a meeting of experts in Buenos Aires held in 2011. The "indeterminate phase" has contributed much to the uncertainty in which the patient is, on one side, and the physician is, on the other, for not knowing the most appropriate behavior to follow. New studies seem to bring some light to the evolutive uncertainty of these patients, that represent the larger number of cases detected currently. The Holter applied routinely to these patients makes possible, in some cases, to identify the patients that will probably evolve towards a chagasic cardiopathy. In this completely asymptomatic phase, the old "indeterminate phase" currently recognized as chronic Chagas disease without cardiopathy, the alterations of the variability of the cardiac frequency and the QT dispersion with the presence of a positive antimuscarinic antibody suggest a compromise of the Autonomous Nervous System in the early phase that could be a premonition of the development of the Chagasic Cardiopathy. The major problem of Chagas disease seems to be the population of patients with positive serology, but without evidence of cardiopathy as the specific therapy could be useful for preventing or delaying the appearance of the Chronic Chagasic Cardiopathy. The Chronic Chagasic Cardiopaty is an almost forgotten diagnosis in Paraguay, in spite of the clear evidences of an estimated number of 164.669 infected patients according to a recent report of the MSPyBS that would lead to an estimated number of 32.934 patients with Chagasic Cardiopathy.
Keywords : Chronic chagasic miocardiopathy; electrocardiogram; echocardiogram; Holter; Chagas disease sero.