Abstract P174: Cardiac Arrest in Patients with Chagas Heart Disease
Introduction: Chagas’ disease, caused by a hemoflagellate, Trypanosoma cruzi, is a parasitic disease widely distributed throughout Latin America, affects an estimated 18 to 20 million people in Central, South America, and the United States. Sudden death is one of the most expressive phenomena of the natural history of Chagas’ disease, affecting individuals in the most productive phases of their lives. Prevalence and outcomes of in-hospital cardiac arrests in patients with Chagas’ heart disease are unknown. Hypotheses: We hypothesized that patients with poor pre-arrest left ventricular systolic function would be less likely to survive to hospital discharge.
Methods: All in-hospital cardiac arrests in adults (≥18 years) were prospectively evaluated at a tertiary cardiac care hospital during a period of twenty six months. Among patients with Chagas’ heart disease were evaluated the outcomes.
Results: Of 800 consecutive index patients, 59 patients (7,4 percent) had documented Chagas’ heart disease, 29 (49,2%) had sustained return of spontaneous circulation; 21 patients (36,2%) were alive in 24 hours, only two patients (3,4%) survive to hospital discharge during the follow-up period. In regard to the model of cardiac arrest in Chagas’ disease, the determining mechanism was ventricular tachycardia or ventricular fibrillation in 11 patients (19%), in 21 patients (35%) asystole, and Pulseless electrical activity in 27 patients The two patients, who had survived, had presented VF. In 96,1% patients with documented pre-arrest echocardiogram, moderate or severe dysfunction of the left ventricular systolic function was confirmed.
Conclusions: Chagas’ heart disease was associated with lower rates of survival to hospital discharge. Furthermore, the moderate or severe myocardial dysfunction in these patients may have contributed to the worse outcomes.