Echinococcosis of the heart

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Echinococcosis of the heart (n=1). Intervention: Surgery and albendazole therapy. Primary outcome: Clinical recovery and recurrence.

Q: What does this research mean for the field?

Surgical cystectomy combined with albendazole therapy successfully treats complex cardiac echinococcosis and prevents short-term recurrence. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Takeshi Kitai; Shinya Ito; Tadaaki Koyama; Yutaka Furukawa

doi:10.1093/eurheartj/ehu136

April 8, 2014European Heart JournalOpen Access

Echinococcosis of the heart

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Key result

Cystectomy plus albendazole successfully resolves complex cardiac echinococcus cyst without recurrence at 5 months.

n=1

Key Points

To describe the clinical presentation, multimodal diagnostic imaging, and management of a rare case of cardiac echinococcosis presenting as cardiac tamponade.
Emergency pericardiocentesis was performed in a 42-year-old man presenting with exertional dyspnoea, followed by transthoracic echocardiography, transoesophageal echocardiography, and cardiac MRI.
Diagnostic and therapeutic cyst evacuation and cystectomy were executed, accompanied by histological evaluation, parasite genotype analysis, and postoperative albendazole therapy.
Histological assessment identified characteristic Echinococcus hooklets with lamellated cyst walls, and genetic analysis confirmed Echinococcus ortleppi (genotype G5).
Surgical cystectomy combined with five months of adjuvant albendazole therapy led to complete symptom resolution with no parasite recurrence at follow-up.

Study Design

Type

Case Report (n=1)

Structured PICO

P

Population

A 42-year-old man presenting with exertional dyspnoea and cardiac tamponade who was diagnosed with cardiac echinococcosis.

I

Intervention

Emergency pericardiocentesis, surgical cyst evacuation and cystectomy, followed by albendazole therapy.

O

Outcome

Symptom resolution and recurrence of the cyst.

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Implication

Highlights the role of multimodality imaging in diagnosing a rare case of cardiac echinococcosis and demonstrates successful management with surgical excision and albendazole.

Abstract

A 42-year-old Nepali man with no medical history presented with exertional dyspnoea for 1 week. Cardiac tamponade was diagnosed and emergency pericardiocentesis showed a haemorrhagic pericardial effusion which was negative for microbiology and malignant cells, and symptoms were markedly relieved. Transthoracic echocardiography (apical four-chamber view) showed the cystic structure with compressing the right cardiac cavities (Panel A). Transoesophageal echocardiography revealed a round, sharply demarcated capsulized cystic mass containing a floating thin curvilinear structure within the right ventricle (RV). (Panel B). Cardiac magnetic resonance imaging (Panel C) showed a complex multi-septated mass. This mass was located between the RV and diaphragm, with infiltration in the pericardium, invading the basal inferolateral segment of the RV wall and it was prolapsed into the RV cavity. Surgery was performed for diagnostic and therapeutic purposes. The cyst was evacuated of the content, followed by cystectomy. The cyst consisted of several minor connective sheaths filled with transparent gelatinous contents (Panel D). Histological examination showed classic hooklets of echinococcus with lamellated cyst walls. Genotype analysis identified Echinococcus ortleppi (Echinococcus granulosus genotype G5) and echinococcosis was definitively diagnosed. Therefore, albendazole therapy was introduced. Five months after surgery, the patient was regularly visiting an outpatient clinic without recurrence or symptoms.

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Cite This Study

Kitai et al. (2014) conducted a case report in Echinococcosis of the heart (n=1). Surgery and albendazole therapy was evaluated on Clinical recovery and recurrence. Surgical cystectomy and albendazole therapy successfully treated a complex cardiac echinococcus cyst, with the patient remaining asymptomatic and recurrence-free at 5 months.

synapsesocial.com/papers/6a8477edf54da20a1578d654 https://doi.org/10.1093/eurheartj/ehu136

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Echinococcosis of the heart

Key Points

Study Design

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Echinococcosis of the heart

Key Points

Study Design

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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