Post by Evan Czulada, MD

Today is #WorldChagasDay. Two weeks ago, I had the opportunity to attend the first-ever US #ChagasDisease Meeting. What stood out most was the contrast: Meaningful progress in screening, management, and risk stratification—yet a disease that still carries devastating consequences. Chagas cardiomyopathy (#CCM) remains one of the most severe non-ischemic cardiomyopathies, driven by its “three-headed monster” of: - Stroke - Heart failure - Sudden cardiac death These outcomes reflect a complex inflammatory process leading to irreversible myocardial fibrosis—often detected too late. At the same time, the field is rapidly evolving: - Multimodal imaging—especially cardiac MRI—is reshaping risk stratification - Long-term monitoring continues to uncover life-threatening arrhythmias, even early in disease - AI-enabled ECG models are showing strong performance for diagnosis, LV dysfunction, and mortality prediction - Advances in electrophysiology, including ablation strategies, are expanding treatment options But the most important takeaway was simple: Early detection and treatment change everything. Most patients are infected in childhood—often without diagnosis or access to therapy. As was powerfully stated during the meeting: “Every adult with Chagas disease is a child who went untreated.” That reality underscores the urgency of improving screening systems, particularly in non-endemic settings where the burden remains under-recognized. This is a major focus of my #StARR work with Jessica Fairley via the National Institute of Allergy and Infectious Diseases (NIAID) and Emory University School of Medicine, where we aim to identify and close screening gaps here in the United States. #CHASM will build off our several ongoing #CCM studies in Bolivia via Johns Hopkins Bloomberg School of Public Health, some of which are nearing completion. Special thanks to Claudia Herrera, Chagas Coalition, and Tulane University Celia Scott Weatherhead School of Public Health and Tropical Medicine for organizing such an important meeting. Honored by the invitation from my mentors Rachel Marcus, David T. Martin, and Bob Gilman. Looking forward to continuing this work—for the patients who need it most. #Chagas #WorldChagasDay #Cardiology #Electrophysiology #GlobalHealth #NTDs