Key result
Pediatric age is linked to a ~279% higher relative rate of ST alterations in acute oral Chagas.
Why the study?
Oral transmission of Chagas disease has become important, but electrocardiographic changes during large outbreaks caused by oral infection are not well described.
Observational (n=103)
In a large outbreak of orally transmitted acute Chagas disease, ECG abnormalities suggestive of acute myocarditis and arrhythmias were highly prevalent, particularly ST alterations in children.
ECG abnormalities frequent in acute oral Chagas; leaves open prognostic value for arrhythmia or HF risk.
BACKGROUND: Chagas disease affects more than 15 million people worldwide. Although vector-borne transmission has decreased, oral transmission has become important. Recently, our group published the clinical and epidemiological characteristics of the largest outbreak of orally transmitted Chagas disease reported till date. OBJECTIVE: To describe electrocardiographic changes occurring in the study population during the outbreak caused by ingestion of contaminated guava juice. METHODS: We evaluated 103 positive cases, of which 76 (74%) were aged ≤ 18 years (average age: 9.1 ± 3.1 years) and 27 (26%) were aged > 18 years (average age: 46 ± 11.8 years). All patients underwent clinical evaluations and ECG. If the patients had palpitations or evident alterations of rhythm at baseline, ambulatory ECG monitoring was performed. RESULTS: A total of 68 cases (66%; 53 children and 15 adults) had ECG abnormalities. Further, 69.7% (53/76) of those aged ≤ 18 years and 56% (15/27) of those aged >18 years showed some ECG alteration (p = ns). ST-T abnormalities were observed in 37.86% cases (39/103) and arrhythmias were evident in 28.16% cases (29/103). ST alterations occurred in 72% of those aged ≤ 18 years compared with 19% of those aged >18 years (p < 0.0001). CONCLUSIONS: This study reports the largest number of cases in the same outbreak of acute Chagas disease caused by oral contamination, with recorded ECGs. ECG changes suggestive of acute myocarditis and arrhythmias were the most frequent abnormalities found.
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Márques et al. (2013) conducted an observational in Acute Chagas disease (n=103). Age ≤ 18 years vs. Age > 18 years was evaluated on ST alterations (p=<0.0001). In an outbreak of orally transmitted acute Chagas disease, ST alterations occurred significantly more often in patients aged ≤ 18 years compared to those > 18 years (72% vs 19%, p<0.0001).
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