CTICasesChagas Cardiomyopathy
Imaging findings
Cine cardiac MRI sequences demonstrate marked thinning of the left ventricular lateral wall and apex associated with regional akinesis and dyskinesis. T2-weighted images show patchy areas of high signal intensity in the apex, lateral wall, and right ventricular apex, indicating active myocardial inflammation. Late gadolinium enhancement (LGE) imaging reveals extensive, patchy, epicardial, mid-myocardial, and transmural enhancement at the apex and lateral wall, with a distinct apical aneurysm.
Key takeaways
Chagas disease is caused by the parasite Trypanosoma cruzi and is a leading cause of non-ischemic cardiomyopathy in Latin America. The classic cardiac MRI signature of Chagas cardiomyopathy includes left ventricular apical and lateral wall thinning, aneurysm formation, and myocardial inflammation. The distribution of late gadolinium enhancement typically shows a non-ischemic pattern, frequently involving the apex and lateral wall, which correlates with areas of chronic fibrotic replacement and microvascular injury.
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