ABC | Volume 110, Nº6, June 2018

Anatomopathological Correlation Arduine & Aiello Female patient with chagas disease, heart failure and cachexia Arq Bras Cardiol. 2018; 110(6):588-596 Figure 1 – Chest X-ray (posterior-anterior view): increased pulmonary vasculature and cardiomegaly (+++). Figure 2 – Chest X-ray (posterior-anterior view): presence of cardiac pacemaker, worse pulmonary congestion, cardiomegaly (+++). and arterial blood pressure levels, hydrochlorothiazide was suspended, and the other medications, maintained. Her laboratory tests (October 2014) showed: hemoglobin, 13.2 g/dL; hematocrit, 43%; leukocytes, 7220/mm³ (normal differential count); platelets, 200000/mm³; total cholesterol, 180 mg/dL; HDL-cholesterol, 73 mg/dL; LDL-cholesterol, 88 mg/dL; triglycerides, 95 mg/dL; glycemia, 94 mg/dL; creatinine, 0.96 mg/dL; sodium, 141 mEq/L; potassium, 4.8 mEq/L; AST, 79 IU/L; ALT, 111 IU/L; uric acid, 4.2 mg/dL; C-reactive protein, 6.78 mg/L; TSH, 2.85 µg/mL; free T4, 1.62 mg/dL. On outpatient follow-up visits (October 2015 and March 18, 2016), she denied dyspnea, chest pain, palpitations and syncope, but complained of dizziness. The ICD/pacemaker assessment was normal. Her chest X-ray (2015) revealed pulmonary congestion and cardiomegaly (Figure 3). On September 22, 2016, the patient was admitted due to decompensated heart failure and bronchopneumonia. She reported progressive worsening of dyspnea, which was then triggered on mild exertion. She denied chest pain and fever, but reported dry cough, lack of appetite and weight loss. 589