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Purpose: To determinate the circadian daily and weekly variations in the incidence of sudden death due to Chagas' disease., Methods: In 50 chronic chagasic individuals with sudden death due to Chagas' disease and in 473 individuals with natural, not sudden death, we analyzed both the day of the week and the time of the death. Statistical tests were applied to determine the significance of the difference between proportions and averages., Results: For the chagasic group the values indicated a highly significant excess of lethality for the period between 12 and 6pm. The occurrence of the sudden death was the same in the different days of the week for both groups., Conclusion: The observed results suggest that the sudden death associated with Chagas' disease has a circadian pattern with a vespertine peak. Weekly variations in the sudden death of chronic chagasic individuals were not detected.

We report a case of sudden death from hemopericardium consequent to spontaneous rupture of the right ventricle in a 49-year-old chronic chagasic woman. To our knowledge, this is the third reported case of spontaneous cardiac rupture with chagasic cardiomyopathy. In our case we believe that the thinning of the anterior right ventricular wall, its large ray curvature and the increased ventricular pressure were factors favoring the rupture. There was no infarction and the chronic cardiopathy was significant. It caused the thinning of the rupture region through chronic myocarditis.

The case reports of three patients with chronic chagasic cardiomyopathy with unusual mechanisms of sudden death are presented. It was unexpected in two of them, one by infarction and the other by bronchopneumonia after gut infarction without mesenteric vessel obstruction. The third had cardiac failure and her expected sudden death was due to cardiac tamponade after spontaneous right ventricular rupture.