[Updated review on the pathophysiology of Chagas cardiomyopathy].

More than 110 years after Chagas disease discovery, some aspects of the mechanisms involved in the physiopathology of heart damage are still unknown. Previously, Trypanosoma cruzi was considered to be the only cause of myocardial injury. Currently, there are other known mechanisms involved in the physiopathology of Chagas heart disease, including the immune-inflammatory response, autoimmunity, microvascular abnormalities and nerve damage, which are interrelated and contribute to cardiac damage. Nowadays, the parasite is the main cause of cardiac damage during the acute stage of Chagas disease and the one that initiates the complex physiopathological network that triggers the other mentioned mechanisms. The consequence of these pathophysiological mechanisms is progressive deterioration of cardiac function that ultimately establishes Chronic Chagasic cardiomyopathy. The aim of this review is to describe and discuss the main physiopathological mechanisms that are currently being postulated with respect to cardiac damage in T. cruzi infection.