Chagas disease (also called American trypanosomiasis) is an infection caused by the parasite Trypanosoma cruzi. This parasite spreads through triatomine bugs, commonly known as kissing bugs. It’s most common in rural areas of Latin America, including parts of Bolivia, Argentina, Paraguay, and Brazil. The parasite has raised the rates of heart disease in these countries, though it’s hard to know exactly by how much. As people who are infected migrate, cases are becoming more frequent in other parts of the world as well.

Most people living with Chagas disease don’t know they’re infected until it starts affecting their heart or digestive system. Here’s what you should know about how Chagas disease can affect the heart, including symptoms, diagnosis, and treatment.

What Is Chagas Heart Disease?

Over time, the parasite that causes Chagas disease can invade heart tissue, causing significant inflammation. Eventually, this inflammatory process can lead to an enlarged heart. Without proper treatment, this can eventually lead to heart arrhythmia (irregular heartbeat), stroke, heart failure (weakened heart muscle), and even death.

Symptoms of Chagas Heart Disease

Chagas heart disease has two stages: acute (early) and chronic (long-term). The acute phase of Chagas disease is usually the first phase of the disease, and it can last for weeks or even months. Some people have no symptoms at this stage, some have mild symptoms, and some experience more severe symptoms. Possible symptoms include:

• Headache
• Vomiting
• Diarrhea
• Body aches
• Fever
• Fatigue
• Significant swelling of the eyelid
• Discoloration or a rash at the bite site
• Swollen lymph nodes
• Loss of appetite
• Enlargement of the liver or spleen

The symptoms of chronic Chagas disease are different. About 30 percent to 40 percent of people living with Chagas disease develop serious complications.

While some affect the heart, others involve different parts of the body. If there’s any chance you have Chagas disease and you notice any of these symptoms, talk to your doctor. They can check your heart for Chagas. Early testing and treatment can help prevent problems before they start or become life-threatening.

Symptoms of chronic Chagas disease include:

• Shortness of breath
• Dizziness
• Heart palpitations or irregular heart beat
• Heart failure
• Cardiac arrest with no other known cause (can cause sudden cardiac death)
• Fainting or feeling like you might faint
• Tiredness
• Chest pain
• Bloating
• Constipation
• Heartburn
• Trouble swallowing
• Sudden stroke

If you notice any of these symptoms, talk to your doctor right away. Call emergency services if needed.

Risk Factors for Chagas Heart Disease

You may be at higher risk of developing Chagas heart disease if:

• You received a blood transfusion or organ transplant between 1990 and 2007 (before routine blood screening began in most areas).
• Your mother had Chagas disease during pregnancy.
• You’ve lived in rural areas of Mexico, South America, or Central America, especially in homes with thatched roofs, mud walls, or no window screens.
• You’ve traveled to the areas listed above and eaten salads or unpeeled or uncooked fruit or vegetables.

If you think you might have Chagas disease, talk to your doctor as soon as possible.

Preventing Chagas Heart Disease

If you live in or visit areas where Chagas disease is common, there are some precautions you can take:

• Use netting to protect yourself from bugs at night.
• Use insect-killing sprays in living spaces
• Check that doors and windows are sealed tightly.
• Don’t eat unpeeled or uncooked fruits and vegetables.
• Avoid sleeping in a house with adobe, mud, or thatch walls.

If you’re pregnant or planning to be and you’ve been in high-risk areas, talk to your doctor about getting tested. This can help prevent passing Chagas disease to your baby.

How Chagas Heart Disease Is Diagnosed

If you or your healthcare provider thinks you might have Chagas disease, you’ll first get a blood test to detect antibodies for the parasite that causes it.

If you test positive, your doctor will probably assess your heart and digestive system to see how the disease has affected your body. They may refer you to a cardiologist (heart specialist) team for the heart tests.

Possible tests for your heart related to Chagas heart disease include:

• An X-ray of your chest — This can show if your heart is enlarged. Some doctors may also order a CT scan.
• An electrocardiogram — This looks at the electrical activity in your heart.
• An echocardiogram — This looks at how your heart moves and functions.
• A heart biopsy — This looks at heart tissue for damage.

After testing, your doctor will explain the results and discuss treatment options.

Treating Chagas Heart Disease

If you find out that you have Chagas disease during the acute phase, you can take medications like benznidazole and nifurtimox that will kill the parasite. These are powerful antiparasitic drugs, but they can cause serious side effects. Your doctor will help you manage these side effects so you can complete the full course of treatment — this gives you the best chance at avoiding chronic complications.

While these medications can’t cure the disease once you’re in the chronic phase, they may still be able to slow its progression. This can help avoid any serious complications.

Research is underway to find new treatment for and ways to prevent Chagas disease. Scientists are working on improving treatments for both acute Chagas disease and chronic Chagas disease, and even a potential vaccine. While these innovations are still being tested, they show that the medical community is committed to helping people living with this diagnosis. Talk to your cardiologist regularly about new treatments, as new options are being approved frequently.

Managing Chronic Chagas Heart Disease

Once Chagas disease has affected your heart, your care team will create a personalized plan tailored to the specific symptoms you’re experiencing. Depending on your symptoms, this may involve getting a pacemaker to help your heart beat regularly, having other surgeries, or even getting a heart transplant. Most likely, your treatment plan will also include medications to manage the problems you’re having with your heart.

Your doctor will probably want to monitor your condition closely. This can help them figure out if you need to adjust your medications or treatments. It can also help them understand exactly what is happening with your heart and track changes in your heart function. Follow up with your healthcare team regularly so you can get the best possible care.

Talk With Others Who Understand

On MyHeartDiseaseTeam, the social network for people with heart disease and their loved ones, more than 121,000 members come together to ask questions, give advice, and share their stories with others who understand life with heart disease.

Have you been affected by Chagas heart disease? What was the first sign that you had it? Share your experience in the comments below, or start a conversation by posting on your Activities page.