Chronic Chagas cardiomyopathy

of terms of the Creative Commons Attribution Non-Commercial License which permits unrestricted noncommercial use, distribution, and reproduction in any medium provided article is properly cited. First described by Carlos Justiniano Ribeiro Chagas (1879-1934) in 1909, Chagas disease (CD) or American trypanosomiasis is caused by the protozoan parasite Trypanosoma cruzi. This zoonotic infectious disease follows a sylvatic cycle where blood-sucking triatomine insect (known as kissing bug or in Portuguese as “barbeiro”), acquire the parasite by sucking small mammals’ blood and transmit to humans through their feces, left close to the bite site. The parasite, in turn, reaches the human blood stream when the parasite-laden feces are dispersed at the itching bite wound. More rarely, transmission may also occur through blood transfusion, congenital, organ transplantation and oral transmission by ingesting contaminated food by infected triatomine or their feces. In addition, the disease may reactivate from the chronic phase when associated with any sort of immunosuppression, including HIV infection.1 In 2012 it was estimated that 8 million persons were infected in South and Central America and Mexico and that 12,500 deaths occur annually due to Chagas disease.2 The natural history of the disease involves an acute phase that lasts between 8 and 12 weeks after Chronic Chagas cardiomyopathy