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      Cardiac Hydatid cysts; presentation and management. A case series

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          Abstract

          Introduction

          Hydatid cyst commonly affects liver and lung. Cardiac Hydatid cyst is an extremely rare disease. The aim of this study is to report the presentation and management of cardiac Hydatid diseases admitted to two major cardiac centers.

          Method

          A retrospective, case series study, conducted in two centers during two years. Each case presented separately regarding presentation, diagnosis and management.

          Results

          Four cases have been reported, age ranged from 14 to 42 years with mean age of 24.75 years. Three patients (75%) were male, one patient (25%) was female. Three cases (75%) had history of chest pain, 2 cases (50%) had palpitation, and one case (25%) had nausea, vomiting and fever. Echocardiography was the initial diagnostic test in 2 cases (50%), final diagnostic test in two cases (50%). In 3 cases (75%) the cyst was found in the left ventricle and one case (25%) in right ventricle. Median sternotomy was performed for all cases.

          Conclusion

          Cardiac Hydatid cyst is a very rare disease. Chest pain is the most common symptom. Surgery is the main modality of treatment.

          Highlights

          • Hydatid disease is a common disease in the endemic area, commonly affecting the liver and lung.

          • Muscular Hydatid disease is a very rare disease, cardiac Hydatid disease is even rarer.

          • The aim of this study is to report 4 cases of cardiac Hydatid disease involving the heart muscles.

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          Most cited references12

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          Surgical treatment of cardiac hydatid disease in 13 patients.

          Cardiac hydatidosis is an uncommon but potentially fatal disease. It remains endemic in developed and developing countries. Its clinical presentation ranges from an absence of symptoms to congestive heart failure or other life-threatening sequelae. Herein, we report our clinical experience with the disease. From 1991 through 2009, 7 male and 6 female patients (mean age, 36 +/- 18.3 yr; age range, 10-68 yr) underwent surgical treatment at our hospital for cardiac hydatid disease. Cardiac hydatidosis was established as a component of multiorgan echinococcosis in 8 patients, and it was diagnosed upon echocardiographic examination in the other 5 during investigation of their nonspecific symptoms. Hydatid cysts were found in the left ventricle (in 5 patients); the right ventricle (in 3); the interventricular septum (in 2); and the interatrial septum, right atrium, and left atrium (in 1 each). All 13 patients underwent sternotomy and surgery under cardiopulmonary bypass. No intraoperative rupture or operative death occurred. The only sequela was complete atrioventricular block that necessitated pacemaker implantation in a patient whose hydatid cyst had involved the basal interventricular septum. All patients underwent subsequent treatment with albendazole (400 mg/d). One patient experienced a recurrence 1 year postoperatively. We discuss our surgical approaches, the outcomes in our patients, and diagnostic and therapeutic recommendations.
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            Surgical treatment of cardiac hydatid disease: A report of 7 cases.

            Cardiac echinococcosis is a rare but potentially very serious complication of hydatid disease. It is a diagnostic and therapeutic challenge due to the variability of signs and symptoms at presentation and to its numerous, often unpredictable, preoperative complications. Our clinical experiences with 7 cases of cardiac echinococcosis are reported, and the diagnostic and therapeutic considerations for the management of patients are discussed, together with a review of the literature.
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              Cardiac Hydatid Cyst: A Case Report

              Hydatid disease commonly involves liver but in rare cases, it can involve cardiac structures. A 75-yr-old farmer from Parsabad-Moghan, northwestern Iran was presented to the Emergency Room of Tehran Imam Khomeini Hospital, Tehran, Iran with dyspnea and without chest pain in 2014. A lesion compatible with hydatid cyst was found in echocardiography and confirmed by serology and MRI. Surgical treatment was done but the patient was died in recovery room because of cardiac arrhythmia. In endemic areas, hydatid cyst should be considered in differential diagnosis of heterogeneous echogenic lesions even if the serologic tests are negative. Physician can use cardiac MRI to earn valuable information about the lesion and its relation to other structures. However, with all of these assessments, surgical removal of cardiac cysts may have some complications.
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                Author and article information

                Contributors
                Journal
                Ann Med Surg (Lond)
                Ann Med Surg (Lond)
                Annals of Medicine and Surgery
                Elsevier
                2049-0801
                07 April 2018
                June 2018
                07 April 2018
                : 30
                : 18-21
                Affiliations
                [a ]College of Medicine, Duhok University, Duhok, Kurdistan, Iraq
                [b ]Sulaimani Cardiac Center, Sulaimani, Kurdistan, Iraq
                [c ]Duhok Cardiac Center, Duhok, Kurdistan, Iraq
                [d ]University of Sulaimani, Old Campus, Sulaimani, Kurdistan, Iraq
                [e ]Kscien Organization for Scientific Research, Sulaimani, Kurdistan, Iraq
                [f ]Sulaimani Teaching Hospital, Sulaimani, Kurdistan, Iraq
                Author notes
                []Corresponding author. University of Sulaimani, Old campus, Sulaimani, Kurdistan, Iraq. fahmi.kakamad@ 123456univsul.edu.iq fahmi.hussein@ 123456univsul.edu.iq
                Article
                S2049-0801(18)30068-2
                10.1016/j.amsu.2018.04.001
                6016321
                29946454
                5641b5b8-7337-4f42-90b5-41073e568a36
                © 2018 The Author(s)

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 18 September 2017
                : 24 March 2018
                : 1 April 2018
                Categories
                Case Report

                hydatid cysts,open heart,left ventricle
                hydatid cysts, open heart, left ventricle

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