Snapshot A 58-year-old man presents to the clinic with a 2 month history of cough, dyspnea on exertion, palpitations, and orthopnea. He immigrated from rural Bolivia when he was 25 years of age and visits Bolivia regularly. Past medical history is unremarkable. Physical exam reveals an anxious-looking man in respiratory distress. Cardiovascular exam reveals an elevated JVD, S3 gallop, and pitting edema of both ankles. There are bibasilar crackles on chest exam and a chest radiograph shows cardiomegaly. Echocardiogram revealed biventricular dilatation with an EF of 25%. Serological testing was positive for Trypanosoma cruzi. Introduction Definition login to view 3 more bullets Epidemiology Incidence login to view 1 more bullet ETIOLOGY Pathogenesis login to view 2 more bullets Presentation Acute phase (lasts 8-12 weeks) login to view 10 more bullets Chronic phase login to view 24 more bullets Studies Blood smear login to view 1 more bullet Polyermase chain reaction (PCR) Serology login to view 1 more bullet Differential Alcohol-induced dilated caridiomyopathy login to view 2 more bullets Treatment Medical login to view 6 more bullets Complications Dilated cardiomyopathy Cardiac arrest Thromboembolic events (e.g., stroke) Bowel ischemia Malnutrition