Chronic Chagas' Heart Disease in a Japanese-Brazilian Traveler. A Case Report

Masayoshi TAKENO; Shinji SETO; Fumitaka KAWAHARA; Shiro YAMACHIKA; Katsusuke YANO; Nobuo TSUDA; Tetsuo YANAGI; Hiroji KANBARA

doi:10.1536/jhj.40.375

Masayoshi TAKENO, Shinji SETO, Fumitaka KAWAHARA, Shiro YAMACHIKA, Katsusuke YANO, Nobuo TSUDA, Tetsuo YANAGI, Hiroji KANBARA

Author information

Masayoshi TAKENO
Third Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
Shinji SETO
Third Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
Fumitaka KAWAHARA
Third Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
Shiro YAMACHIKA
Third Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
Katsusuke YANO
Third Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
Nobuo TSUDA
Pathology Division, Nagasaki University Hospital, Nagasaki, Japan
Tetsuo YANAGI
Department of Protozoology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
Hiroji KANBARA
Department of Protozoology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan

Keywords: Chagas' disease, Trypanosoma cruzi, Dilated cardiomyopathy, Ventricular aneurysm, Right bundle branch block, Left anterior fascicular block

JOURNAL FREE ACCESS

1999 Volume 40 Issue 3 Pages 375-382

DOI https://doi.org/10.1536/jhj.40.375

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Abstract

A 57-year-old Japanese-Brazilian man, visiting Japan for only 9 days, was admitted to our hospital due to syncope and frequent ventricular premature beats. He grew up in a rural area of Brazil and moved to Sao Paulo in 1959 when he was 20 years old. We suspected chronic Chagas' heart disease, ie., dilated cardiomyopathy with apical ventricular aneurysm, right bundle branch block with left anterior fascicular block, and various arrhythmias including supraventricular premature beats, ventricular premature beats and non-sustained ventricular tachycardia because he showed typical echo- and electrocardiographic features of the disease. Coronary arteriograms were normal, and left ventriculogram confirmed the existence of apical ventricular aneurysm. A left ventricle biopsy specimen showed hypertrophic cardiac muscle with mild fibrosis. The diagnosis of chronic Chagas' disease was finally confirmed by the demonstration of Trypanosoma cruzi itself in the blood as well as Trypanosoma cruzi antibodies.

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