Chronic Chagas' heart disease

Coronary angiography and left ventriculography from a patient with chronic Chagas' disease complaining of chest pain. Myocardial perfusion imaging showed a large defect involving the anterolateral, apical, and posterolateral walls. Coronary angiography (upper panel) demonstrated normal right and left coronary arteries. However, the left ventriculogram in the right anterior oblique (RAO, middle panel) and left anterior oblique (LAO, bottom panel) views show normal global left ventricular function but mild hypokinesis of the anterolateral, apical, and posterolateral walls (arrows).