Chagas disease and stroke

Abstract

Chagas disease is a neglected infectious disease in the tropics and an emerging health problem in Europe and the USA. In the past decade, a link has been recorded between ischaemic stroke and Trypanosoma cruzi infection in several epidemiological studies, and an increase in stroke prevalence is expected with the ageing of the population infected with T cruzi in Latin America. Heart failure, mural thrombus, left ventricular apical aneurysm, and several types of cardiac arrhythmias are associated with stroke in Chagas disease. Stroke could also be the first sign of Chagas disease in asymptomatic patients and those with mild systolic dysfunction, so patients with stroke who are from endemic regions should be screened for T cruzi infection. The most frequent stroke syndrome seen in patients with Chagas disease is partial anterior circulation infarction. Stroke recurrence has been estimated to occur in 20% of patients, and secondary prevention measures include chronic anticoagulation in cardioembolic chagasic stroke. So far, no studies have been done to assess the effect of chagasic stroke on vascular dementia.