Development of Chagas Cardiac Manifestations Among Texas Blood Donors

• Chagas disease cardiac manifestations were seen in 41% of Texas blood donors during a cross-sectional analysis.
• Thirty-six percent of Chagas-positive blood donors were suspected locally acquired cases, putting them at high risk for being mistreated during their follow-up clinical evaluations despite having positive test results from the blood bank.
• Blood donors with positive test results for the parasite that causes Chagas disease should be closely monitored for the development of cardiac manifestations.

Chagas disease, infection with the parasite Trypanosoma cruzi, has recently been identified as an important emerging parasitic disease in the United States. To describe the cardiac abnormalities in T. cruzi–positive blood donors in southeastern Texas, a pilot study of donors who had screened positive from 2007 to 2012 was performed. This one-time assessment included (1) a questionnaire to evaluate the source of infection, cardiac symptoms, and health co-morbidities; (2) electrocardiography; (3) echocardiography if electrocardiographic findings were abnormal; and (4) measurement of a high-sensitivity troponin T biomarker. Of those with confirmed infection, 41% (7 of 17) had electrocardiographic abnormalities consistent with Chagas cardiomyopathy. In addition, 36% (6 of 17) were suspected to be locally acquired cases. High-sensitivity troponin T serum levels increased with cardiac severity. In conclusion, cardiologists should consider Chagas disease in their differential diagnoses for patients who may have clinically compatible electrocardiographic changes or nonischemic cardiomyopathy, even if the patients have no histories of residing in Chagas-endemic countries.