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  4. how to diagnose and differentiate Chagas disease-Chagas disease is easily confused

how to diagnose and differentiate Chagas disease-Chagas disease is easily confused

how to diagnose and differentiate Chagas disease-Chagas disease is easily confused

Differential diagnosis of Chagas disease

It should be differentiated from coronary heart disease, idiopathic dilated cardiomyopathy, alcoholic cardiomyopathy, etc.

1. Coronary heart disease This disease can affect the myocardium just like trypanomyocarditis, causing the heart to expand, including arrhythmia and heart failure. Coronary heart disease is more common in men over 45 years of age and women after menopause, and it is more common in older persons. Coronary heart disease often has a variety of predisposing factors, such as hyperlipidemia, hypertension, diabetes, obesity, and family history. Trypanosoma cardiomyopathy has a history of living in an endemic area of ​​Trypanosoma cruzi. The serological test of Trypanosoma cruzi is positive, and there are often clinical manifestations of Chagas heart disease that can be distinguished from the disease.

2. Dilated cardiomyopathy may have a family history, long course, slow progress, dilated cardiomyopathy, the heart is often significantly enlarged, there may be arterial embolism, virus isolation is negative, serum virus neutralizing antibody titer does not increase in a short time, electrocardiogram often There are various arrhythmias, and sometimes pathological Q waves can be seen. Symptoms of heart enlargement and heart failure may appear in the late stage. Trypanosoma cruzi myocarditis has a history of living in areas where Trypanosoma cruzi is endemic, and the serology test of Trypanosoma cruzi is positive and typical clinical symptoms and signs.

3. Alcoholic cardiomyopathy patients with alcoholic cardiomyopathy have a history of heavy drinking and long-term drinking (mostly for more than 10 years, with a daily amount of pure ethanol 125ml); heart enlargement, arrhythmia, chest pain, high blood pressure and other changes occur, and congestion may occur in the late stage Exhaustion. Although it is similar to some of the symptoms and signs of this disease, it should be distinguished from the epidemiological history, the positive serological test of Trypanosoma cruzi and the frequent concurrent multiple organ expansion.

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