In a cohort of patients with Chagas' heart disease, multivariate analysis was used to identify six risk factors for death: New York Heart Association class III or IV, cardiomegaly, left ventricular systolic dysfunction, nonsustained ventricular tachycardia, low QRS voltage, and male sex. These variables were incorporated into a risk score that was validated in a second cohort of patients. In patients with Chagas' heart disease, multivariate analysis was used to identify six risk factors for death: New York Heart Association class III or IV, cardiomegaly, left ventricular systolic dysfunction, nonsustained ventricular tachycardia, low QRS voltage, and male sex. Chagas' disease is due to a parasitic infection with Trypanosoma cruzi . It is transmitted to humans through the feces of infected bloodsucking insects in areas in which the disease is endemic and, occasionally, by nonvectorial mechanisms such as blood transfusion. Chagas' disease is a serious problem in most Latin American countries, with 18 million persons chronically infected and approximately 200,000 new cases each year. 1 Cardiac involvement is the main cause of death. 2 The clinical course of Chagas' heart disease is variable, and the identification of patients at risk for death remains a challenge. Previous reports 3 – 13 demonstrated that many . . .