Dilated Cardiomyopathy in the Context of Chagas Disease

Dilated cardiomyopathy is a common and severe manifestation of chronic Chagas’ disease, caused by the protozoan Trypanosoma cruzi. In this context, the myocardium becomes progressively weakened and dilated due to a combination of direct parasitic damage, chronic inflammation, and autoimmune responses. The resulting cardiomyopathy is characterized by ventricular enlargement, systolic dysfunction, and myocardial fibrosis, often leading to arrhythmias, thromboembolic events, and heart failure. Chagas-related dilated cardiomyopathy is particularly prevalent in endemic regions of Latin America but is increasingly seen in non-endemic countries due to migration. Diagnosis typically involves serologic confirmation of T. cruzi infection alongside echocardiographic evidence of cardiac dilation and dysfunction. Management includes standard heart failure therapies, arrhythmia control, and in some cases, antiparasitic treatment in selected patients.