Newly diagnosed heart failure due to Chagas disease cardiomyopathy in a non-endemic area.

A man in his 40s, originally from Brazil, presented to the emergency department with dyspnoea and fatigue with marked limitation in activities of daily living. A transthoracic echocardiogram revealed reduced left ventricular systolic function and an apical thrombus in the left ventricle. Cardiac magnetic resonance confirmed a dilated cardiomyopathy with biventricular involvement and severe left ventricular ejection fraction impairment. Serologic tests (two different methods) were positive for Trypanosoma cruzi immunoglobulin (Ig)G antibody. The patient was discharged on guideline-directed medical therapy for heart failure (HF) and anticoagulation.Chagas disease is a parasitic disease that affects millions in Latin America and became global due to population migration. Cardiac manifestations can develop decades after primary infection. This disease should be considered in patients presenting with HF and ventricular arrhythmias with suggestive epidemiological background and cardiac imaging findings.