Which of the following are symptoms of acute Chagas disease?

• A. Weird heart rhythm, dilated heart not pumping well, dilated esophagus/colon making it hard to eat or poop
• B. Severe joint pain, rash, and itching
• C. Chronic cough, weight loss, night sweats
• D. Headache, dizziness, and blurred vision

Answer: (A)

Recognizing acute Chagas disease hinges on identifying cardiac involvement during the acute phase, especially arrhythmias and reduced heart pumping from myocarditis. In the acute stage the parasite can provoke inflammation of the heart, leading to abnormal rhythms and weakened cardiac function, which are hallmark life-threatening features of the early infection. The other options describe symptoms that aren’t characteristic of the acute cardiac manifestations of Chagas or point to conditions outside the usual acute presentation (joint pain with rash suggests other inflammatory or allergic processes; chronic TB-like symptoms aren’t specific to acute Chagas; headaches with dizziness and blurred vision are nonspecific and don’t capture the typical acute cardiac involvement). While megadilation of the esophagus or colon is a known complication of chronic Chagas, the presence of heart rhythm disturbances and poor cardiac pumping aligns with the acute phase’s presentation, making this choice the best match for acute Chagas disease.