RESUMEN
Human infection with Trypanosoma cruzi, the aetiological agent of chagas' heart disease, is believed to be sporadic or non-existent in Trinidad. This study was undertaken to investigate whether human infection with T. cruzi occurs in Trinidad and whether this infection is associated with chagas' heart disease. Peripheral blood was withdrawn aseptically from 192 cardiac patients seen at the General Hospital, San Fernando from May to August, 1992. Sera were tested for T. cruzi IgG antibodies by an ELISA test and Giemsa-stained thick and thin smears of fresh blood examined for trypomastigotes of T. cruzi. Following physical examination, chest X-ray and 12-lead ECG, patients with findings consistent with ischaemic heart disease, hypertension, vavular heart disease, cardiomyopathy, diabetes, alcoholism, cigarette smoking and blood cholesterol > 220 mg/dl were excluded from further study. The remaining patients were subjected to echocardiography. Seventy-two (37.5 per cent) were positive for T. cruzi antibodies and 49 (68 per cent) of these had T. cruzi trypomastigotes in peripheral blood. After further review of 37 of these 49 seropositive parasite-positive patients, 12 were excluded on the basis of findings compatible with other cardiac diseases. Apical aneurysm, a cardinal sign of Chagas' disease, was found in the left and/or right ventricle of the heart in 21 patients. Our results present conclusive evidence that T. cruzi infection occurs in humans in Trinidad and that this infection is associated with cardiac pathology consistent with that of Chagas' heart disease (AU)