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      Heart echinococcus cyst as an incidental finding: early detection might be life-saving

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          Abstract

          We present a 46-year-old female smoker who was admitted to the emergency department of our hospital due to cough with blood-tinged sputum for the last four days before admission. Using echocardiography and Multi-Detector Computed Tomography (MDCT) heart Echinococcosis was diagnosed. Echinococcosis is a severe health issue in some geographical regions of the world. Hydatid infection of the heart is rare and the clinical presentation is usually insidious but there is always the lethal hazard of cyst perforation. Early diagnosis and an integrated treatment strategy are crucial. The results of surgical treatment of heart echinococcosis are better than the conservative strategy only. Extraction of the cyst combined with chemotherapy peri or post operative aiming to decrease the recurrences, consists the lege artis method of encountering this medical entity. Surgical excision was performed and the patient had an uneventful recovery and follow up at six and twelve months.

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          Cardiac hydatid disease: CT and MRI findings.

          Bledi Cekrezi, Ege Terzibasioglu, Memduh Dursun … (2007)
          The purpose of this article is to review the CT and MRI findings of cardiac hydatid disease. CT and MRI are helpful for localizing and defining the morphologic features of hydatid cysts. Specific signs include calcification of the cyst wall, presence of daughter cysts, and membrane detachment. CT best shows wall calcification, whereas MRI depicts the exact anatomic location and nature of the internal and external structures.
          Article 0 comments Cited 37 times – based on 0 reviews     Review now
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            A clinical dilemma: cardiac and pericardiac echinococcosis.

            C.Levent Birincioğlu, Haşmet Bardakçi, Seref Küçüker … (1999)
            Cardiac and pericardial echinococcosis as a life-threatening disease may present with a clear picture most of the time, however it may also become a clinical puzzle. In the period between 1977 and 1998, 14 patients were operated on with the diagnosis of cardiac and pericardial echinococcosis. Nine patients were operated on with standard cardiopulmonary bypass (CPB) techniques, and the remaining 5 patients were operated on without CPB. Transesophageal echocardiography (TEE) or intraoperative surface echocardiography were used to plan and perform the operation for the late cases. One patient died during the postoperative period due to the rupture of interventricular septum. All other patients survived the perioperative period, received mebendazole treatment, and exhibited no recurrence during the follow-up. The definitive treatment is the surgical extraction of the cyst. Because the clinical picture may vary according to the number, size, and location of cysts, as well as complications, cardiac echinococcosis should be remembered and included in the differential diagnosis to achieve the treatment. Intraoperative surface echocardiography is of paramount value for diagnosis and planning the management of a successful surgery.
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              Fifteen year surveillance of echinococcal heart disease from a referral hospital in Greece.

              L Anthopoulos, F Kardaras, C Lolas … (1996)
              Ten cases of hydatid heart disease were treated over a 15-year period (1980-1995). Cysts were located in the left ventricular wall (four patients), right ventricular wall (one patient), interventricular septum (one patient), interatrial septum (one patient), right atrium (one patient), pericardial cavity (one patient) and in multiple loci (one patient). Apart from two asymptomatic cases, clinical manifestations included chest pain (four patients), anaphylactic shock (one patient), constrictive pericarditis (one patient), congestive heart failure (one patient) and arterial embolism (one patient). Computed tomography was found useful in the detection of hydatid cysts and also in the determination of their morphology. Magnetic resonance was performed in three patients, with satisfactory imaging. Three out of the 10 patients died: rupture of pulmonary echinococcal cyst (one patient), massive pulmonary hydatid embolism (one patient) and rupture of an undiagnosed hydatid cyst of the right atrium during cannulation for cardiopulmonary bypass (one patient). One other patient experienced recurrent systemic embolism and became hemiplegic. Six patients were successfully treated. In five patients, the cysts were excised by open heart surgery, while in one by pericardiectomy. In addition, antiparasitic drugs were successfully used in two patients with long-term satisfactory results. In conclusion, cardiac echinococcosis is associated with an increased risk of potentially lethal complications. Newer techniques of cardiac imaging have helped locate the cysts while surgical removal may offer cure. Some patients responded to specific long-term drug treatment.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Cardiothorac Surg
                Title: Journal of Cardiothoracic Surgery
                Publisher: BioMed Central
                ISSN (Electronic): 1749-8090
                Publication date Collection: 2010
                Publication date (Electronic): 8 December 2010
                Volume: 5
                Page: 124
                Affiliations
                [1 ]Department of Cardiology, Patras University School of Medicine, Patras, Greece
                [2 ]Department of Cardiothoracic Surgery, Patras University School of Medicine, Patras, Greece
                [3 ]Department of Radiology, Patras University School of Medicine, Patras, Greece
                [4 ]Department of Pathology, Patras University School of Medicine, Patras, Greece
                Article
                Publisher ID: 1749-8090-5-124
                DOI: 10.1186/1749-8090-5-124
                PMC ID: 3004882
                PubMed ID: 21143844
                SO-VID: d5896ebe-d400-4e5a-b9b8-23e8310045e0
                Copyright © Copyright ©2010 Tsigkas et al; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<url>http://creativecommons.org/licenses/by/2.0</url>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 4 October 2010
                Date accepted : 8 December 2010
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Surgery
                Data availability:
                ScienceOpen disciplines: Surgery

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