Clinically, cChHD is a dilated cardiomyopathy, characterized by heart failure, heart block, malignant arrhytmias, pulmonary and systemic embolia, and quite commonly, sudden death.
Histological examination reveals mononuclear cell infiltration, myocyte damage, and fibrosis.
Parasite cells are rarely detected in chagasic myocarditis. However, PCR amplification and immunohistochemical techniques revealed the presence of parasite DNA and proteins very close to inflammatory foci, implying an active and efficient breakdown of parasite cells at the site of inflammation. These findings suggest that heart parasitation is the primary stimulus for the perpetuation of myocardial inflammation, and more generally, is responsible for increased serological response to the parasite. Two B cell epitopes were found to be implicated. Both sequences possess negatively charged stretches of residues, which may contribute to their antigenicity, and to their putative ability to induce antibodies with functional activity against cardiac receptors.