Trypanosoma cruzi (T. cruzi) infection is endemic in Latin America and is becoming a worldwide health burden. It may lead to heterogeneous phenotypes. Early diagnosis of T. cruzi infection is crucial. Several biomarkers have been reported in Chagas heart disease (ChHD), but most are nonspecific for T. cruzi infection. Prognosis of ChHD patients is worse compared with other etiologies, with sudden cardiac death as an important mode of death. Most ChHD patients display diffuse myocarditis with fibrosis and hypertrophy. The remodeling process seems to be associated with etiopathogenic mechanisms and neurohormonal activation. Pharmacological treatment and antiarrhythmic therapy for ChHD is mostly based on results for other etiologies. Heart transplantation is an established, valuable therapeutic option in refractory ChHD. Implantable cardioverter-defibrillators are indicated for prevention of secondary sudden cardiac death. Specific etiological treatments should be revisited and reserved for select patients. Understanding and management of ChHD need improvement, including development of randomized trials.

中文翻译：

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慢性恰加斯心脏病管理

克氏锥虫 (T. cruzi) 感染在拉丁美洲流行，正在成为世界范围的健康负担。它可能导致异质表型。T. cruzi 感染的早期诊断至关重要。几种生物标志物已报道在恰加斯心脏病 (ChHD) 中，但大多数对克氏锥虫感染没有特异性。ChHD患者的预后较其他病因更差，心源性猝死是重要的死亡方式。大多数 ChHD 患者表现为弥漫性心肌炎伴纤维化和肥厚。重塑过程似乎与病因机制和神经激素激活有关。ChHD 的药物治疗和抗心律失常治疗主要基于其他病因的结果。心脏移植是治疗难治性 ChHD 的一种既定的、有价值的治疗选择。植入式心脏复律除颤器适用于预防继发性心源性猝死。应重新审视特定的病因治疗，并为特定患者保留。对 ChHD 的理解和管理需要改进，包括开发随机试验。