Continued assessment of temporal trends in mortality and epidemiology of specific heart failure in South
America is needed to provide a scientific basis for rational allocation of the limited health care resources, and strategies to
reduce risk and predict the future burden of heart failure. The epidemiology of heart failure in South America was reviewed.
Heart failure is the main cause of hospitalization based on available data from approximately 50% of the South
American population. The main etiologies of heart failure are ischemic, idiopathic dilated cardiomyopathy, valvular, hypertensive
and chagasic etiologies. In endemic areas, Chagas heart disease may be responsible by 41% of the HF cases.
Also, heart failure presents high mortality especially in patients with Chagas etiology. Heart failure and etiologies associated
with heart failure may be responsible for 6.3% of causes of deaths. Rheumatic fever is the leading cause of valvular
heart disease. However, a tendency to reduction of HF mortality due to Chagas heart disease from 1985 to 2006, and reduction
in mortality due to HF from 1999 to 2005 were observed in selected states in Brazil. The findings have important
public health implications because the allocation of health care resources, and strategies to reduce risk of heart failure
should also consider the control of neglected Chagas disease and rheumatic fever in South American countries.
Keywords: Heart failure, cardiomyopathy, rheumatic fever, Chagas’ disease, epidemiology, valve disease, rheumatic fever,
endomyocardial fibrosis, hypertrophic cardiomyopathy, restrictive cardiomyopathy, treatment, prognosis.
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