ABSTRACT
Chronic Chagas heart disease has different clinical manifestations including arrhythmias, heart failure, and stroke. Chest pain is one of the most common symptoms and when associated with changes in the electrocardiogram, such as T-wave changes, electrically inactive areas, and segmental wall motion abnormalities, may lead to a misdiagnosis of acute coronary syndrome (ACS). Here, we describe two patients with Chagas heart disease and syncope due to sustained ventricular tachycardia who were misdiagnosed with ACS, and discuss the role of novel imaging modalities in the differential diagnosis and risk stratification.
Subject(s)
Arrhythmias, Cardiac/etiology , Chagas Cardiomyopathy/complications , Aged , Amiodarone/administration & dosage , Amiodarone/therapeutic use , Anti-Arrhythmia Agents/administration & dosage , Anti-Arrhythmia Agents/therapeutic use , Clopidogrel/administration & dosage , Clopidogrel/therapeutic use , Defibrillators, Implantable , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Platelet Aggregation Inhibitors/administration & dosage , Platelet Aggregation Inhibitors/therapeutic useABSTRACT
O sistema nervoso autônomo (SNA) desempenha um papel fundamental na regulação da fisiologia cardiovascular, atuando sobre o cronotropismo, inotropismo, dromotropismo, resistência vascular e fluxo sanguíneo miocárdico, tanto em indivíduos saudáveis como em portadores de cardiopatias. Entretanto, o desequilíbrio entre os sistemas simpático e parassimpático, com hiperestimulação adrenérgica e consequente aumento dos níveis de catecolaminas circulantes, constitui a principal condição fisiopatológica da insuficiência cardíaca, responsável por progressão da doença arritmias ventriculares e morte súbita. A neurotransmissão adrenérgica cardíaca...
