Chagas Disease
How is Chagas Disease transmitted?
The kissing bug.
What are the two forms of HF?
1. HF with reduced LVEF
2. HF with preserved LVEF
What is AI?
It is the result of an incompetent aortic valve that allows backward diastolic flow back into the LV through the closed aortic valve.
You get a P1/2T of 750. How severe is your AI?
Mild.
What are some symptoms of AI?
-Chest Pain
-Dizziness
-Syncope
Where is Chagas typically found?
The non-island nations of Latin America.
What is a cause of HF?
-Decreased myocardial contractility
-Increased myocardial workload
-Filling Disorders
-Dysrhythmias
Name 3 causes of AI.
-Endocarditis
-Bicuspid AoV
-AS
-Aortic dilation
-RHD
-Incomplete Closure
You get a P1/2T of 50. How severe is your AI?
Chest pain, Dyspnea, SOB at night, edema, pulmonary edema, weight gain due to fluid retention, coughing, fatigue.
What is the most common echo finding in Acute Chagas Disease?
Pericardial Effusion.
How is HF Diagnosed?
from clinical findings, structural, and functional cardiac changes.
Austin Flint murmur. (Low pitched, mid-diastolic rumble at the apex.)
You get a P1/2T of 300. How severe is your AI?
Moderate.
The following are symptoms of what:
-Systemic congestion
-Venous congestion
-Edema in lower extremities
Right sided HF.
What can Chagas Disease eventually lead to if it is not caught early enough?
Heart Failure.
What are some echo findings of HF?
-Decrease LV and RV function
-Increased LV and RV size
-Regurgitation is probable
What is the treatment for AI?
Eventually, an AoV replacement may be needed, preferably before the LV is compromised.
Typically we will use the 5 Chamber and 3 Chamber.
What is the most common symptom of Chagas Disease?
Most people remain asymptomatic. If they are symptomatic, most of the time a common symptom is HF.
What are the three stages of Chagas Disease?
Acute, Indeterminate, and Chronic.
What are the treatments used for HF?
-Medical Therapy
-Intra-aortic balloon pump
-LVAD
-Heart Transplant
What complication will AI eventually lead to?
Long standing AI will lead to LV Volume Overload which will lead to LV Dilation and that will lead to decreased LV function and that will eventually lead to HF.
How do we assess AI Severity?
-CW the AoV with the focus on AI.
-Acquire AI Peak Velocity.
-Acquire AI Deceleration slope.You put the probe down and see a LV aneurysm in the apex. Of the three things we talked about, which is it most likely to be?
Chagas Disease.