Long-term adverse outcomes in Chagas' disease are related to functional, electrical and morphological abnormalities observed in the heart of infected subjects at disease presentation. Both development of acute atrial fibrillation during the time course of the disease and orally transmitted trypanosome infection are further harbingers of poor prognosis. Chagas' disease is a challenging condition in the 21st century, and health care providers and governments are urged to implement joint actions to reduce the impact of the disease by developing preventive actions.