The Pivotal Role of Cardiac Magnetic Resonance Imaging in Diagnosing Chronic Chagas Cardiomyopathy.

Chronic Chagas cardiomyopathy (CCM) is a progressive condition marked by myocardial fibrosis, which heightens the risk of severe ventricular arrhythmias (eg, ventricular fibrillation, ventricular tachycardia). Prompt recognition and intervention are particularly crucial in nonendemic regions where CCM often goes underdiagnosed. Here, we discuss 2 cases of Hispanic patients without prior Chagas disease history, each presenting with ventricular fibrillation cardiac arrest and sustained ventricular tachycardia, respectively. Cardiac magnetic resonance was instrumental in diagnosing significant myocardial fibrosis and scarring indicative of CCM. Both patients received automatic implantable cardioverter-defibrillators for secondary prevention of sudden cardiac death, alongside guideline-directed medical therapy, leading to notable clinical improvement. These cases underscore the vital role of cardiac magnetic resonance in detecting myocardial fibrosis and guiding therapy for high-risk patients, illustrating how increased awareness and advanced imaging can enable timely diagnosis and potentially lifesaving treatments in nonendemic areas.