Sudden Death in Indeterminate Chagas disease is Uncommon. A Systematic Review

Julián González, Francisco Azzato, Giusseppe Ambrosio, José Milei


Chagas disease is a serious health care problem in Latin

America due to its high prevalence, morbidity and mortality.

The migration from Latin American countries to the United

States and Europe has disseminated a significant number

of infected subjects. Most patients present the indeterminate

form of the disease and remain without symptoms for

decades. However, some groups believe that patients with

the indeterminate form are at high risk for developing

sudden death although no studies have been designed to

investigate this issue.

We conducted a systematic review of follow-up studies

in patients with asymptomatic Chagas disease, normal ECG

and known cause of death. We found 15 articles including

9382 patients. Mortality rate in asymptomatic patients with

normal ECG was very low (0.92%) and similar to that of

controls without Chagas disease (p=0.38).

This systematic review shows that sudden death is uncommon

in the indeterminate form of the disease and that

the risk of death is similar to that of the general population.

Thus, these patients should be allowed to lead a normal

working life and to practice physical activity, without alarming

them unnecessarily about their condition or indicating

sophisticated and expensive studies. Regular follow-up is

necessary as the death risk increases considerably when

the disease progresses to the cardiac form.

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Revista argentina de cardiología. ISSN en línea 1850-3748. Argentine journal of cardiology (English ed. Online ISSN 2314-2286) Sociedad Argentina de Cardiología. Azcuénaga 980 (C1115AAD),Ciudad Autónoma de Buenos Aires, República Argentina. Tel. (54 11) 4961-6027/8/9 Fax: 4961-6020