Table 1.

Symptoms and Signs of Different Manifestations of Chagas Disease

Stage	Symptoms and Signs on Physical Examination	Potential Radiographic and Cardiac Findings
Acute	Often asymptomatic with normal physical examination findings May have chagoma, fever, lymphadenopathy, or hepatosplenomegaly Myocarditis or encephalitis (rare)	Evidence of myocarditis on electrocardiogram and echocardiogram (rare)
Congenital	Often asymptomatic with normal physical examination findings May have low birthweight, prematurity, low Apgar scores, hepatomegaly, or splenomegaly Hydrops fetalis (rare)	–
Indeterminate	Asymptomatic (no signs on physical examination)	Normal
Chronic (cardiac)	Symptoms include palpitations, lightheadedness, chest pain, symptoms of heart failure (e.g., peripheral edema, orthopnea) Physical examination may show irregular cardiac rhythm, signs of heart failure or stroke	Electrocardiogram: Conduction system abnormalities, including right bundle branch block, left anterior fascicular block, bifascicular block, first-degree atrioventricular block, ventricular premature beats, atrial fibrillation, bradyarrhythmia, tachyarrhythmia (e.g., atrial fibrillation, ventricular tachycardia) Echocardiogram: Regional wall motion abnormalities, dilated cardiomyopathy, reduced ejection fraction, apical aneurysm
Chronic (gastrointestinal)	Symptoms include abdominal pain, dysphagia, odynophagia, regurgitation, and constipation Signs include weight loss Symptoms of colonic torsion (rare)	Barium swallow, barium edema, chest/ abdominal CT scan: Megaesophagus or megacolon
Reactivation (patients with HIV)	Symptoms and signs of meningoencephalitis	May have central nervous system lesions on imaging (CT, MRI)
Reactivation (transplant recipients, immunosuppressed patients)	Cutaneous nodules, myocarditis, meningoencephalitis	Echocardiogram may show myocarditis

CT = computed tomography; MRI = magnetic resonance imaging.