ABC | Volume 112, Nº3, March 2019

Original Article Ortiz et al Cardiac evaluation in acute CD Arq Bras Cardiol. 2019; 112(3):240-246 Table 2 – Electrocardiogram, transthoracic echocardiogram alterations of acute Chagas’ disease patients before and after treatment Variable Group (n = 63) Pre-treatment Post-treatment Electrocardiogram (n = 63) (n = 48) Ventricular reporalization alteration 8 (13%) 4 (8%) Left anterior fascicular block 1 (2%) 1 (2%) Right bundle branch block 1 (2%) 1 (2%) Right bundle branch block + left anterior fascicular block 2 (3%) 2 (4%) Low QRS voltage 2 (3%) - Bradycardia - 3 (6%) Incomplete right bundle branch block 1 (2%) 2 (4%) Ventricular extrasystols 1 (2%) 1 (2%) 1 (2%) - Tachycardia 2 (3%) - Normal 44 (70%) 34 (71%) Echocardiogram (n = 31) (n = 25) Pericardial effusion 3 (10%) - Left ventricular dysfunction 1 (3%) - Normal 27 (87%) 25 (100%) Data are expressed as frequency and in parenthesis are the corresponding percentage for each group. Table 3 – Frequency of ECG results before and after treatment Pre-treatment ECG Post-treatment ECG Normal % Altered % Total Normal 30 62.5 5 10.4 35 Altered 4 8.3 9 18.7 13 Total 34 - 14 - 48 ECG: electrocardiogram. Table 4 – Frequency of TTE results before and after treatment Pre-treatment TTE Post-treatment TTE Normal % Altered % Total Normal 21 86.9 0 - 21 Altered 4 13.1 0 - 4 Total 25 - 0 - 23 TTE: transthoracic echocardiogram Conclusion In our study, we demonstrated the presence of 33%of patient with cardiac alterations in the acute phase of CD. Althoughmost of the cases were located in the Southwest mesoregion, the higher frequency of cardiac alterations belonged to the Central Amazonas mesoregion and isolated acute cases. Although cardiac alterations were present in low frequency during the pre-treatment phase, this clinical condition suggests that there is a new epidemiological profile in the state of Amazonas which differs with the profile present in neighbouring states. This changing scenario might be associated with the T. cruzi strain, but no more can be specified. Most patients followed up in this study had a successful outcome, however, in some of them, the cardiac alterations persisted or even, developed afterwards. Therefore, it is evident the need to reinforce surveillance actions for immediate diagnosis and treatment, as well as long-term and continuous cardiac, follow up of patients with acute CD in order establish preventive measures and improve the prognosis of this group of patients in our region. 244