1
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Purbey N, Patil A, Bharti S, Chandra K, Ranjan S. Incidental finding of cardiac hydatid cyst during autopsy. Autops Case Rep 2024; 14:e2024501. [PMID: 39021463 PMCID: PMC11253903 DOI: 10.4322/acr.2024.501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 05/01/2024] [Indexed: 07/20/2024]
Abstract
Hydatidosis or echinococcosis is an endemic parasitic disease caused by the ingestion of eggs of echinococcal species worldwide. In India, the annual incidence varies from 1 to 200 per one 100,000 hab., with the highest prevalence reported in the Indian states of Andhra Pradesh and Tamil Nadu. The dog is the definitive host, while humans, sheep, and cattle are intermediate hosts. The disease usually involves the liver and lungs, with the kidney and other organs rare involvement. Cardiac hydatidosis is still further rare, seen in 0.2% to 2% of the patients who remain asymptomatic until the development of its complications. Sudden deaths in cardiac echinococcosis are mostly attributed to cardiac arrhythmias, coronary artery diseases, valvular diseases, cardiomyopathies, pericarditis, and cardiac tamponade. We, herein, report a rare case of cardiac hydatid cyst incidentally found during the autopsy of a 26-year-old male who died due to electrical injuries. A single greyish-white cystic mass measuring 1.5cm X 1.2cm was detected on the left anterior ventricular wall 4 cm above the apex and was confirmed microscopically as a hydatid cyst. The cause of death was attributed to external injury.
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Affiliation(s)
- Nishant Purbey
- All India Institute of Medical Sciences, Department of Forensic Medicine and Toxicology, Patna, Bihar, India
| | - Amit Patil
- All India Institute of Medical Sciences, Department of Forensic Medicine and Toxicology, Patna, Bihar, India
| | - Shreekant Bharti
- All India Institute of Medical Sciences, Department of Pathology, Patna, Bihar, India
| | - Keshav Chandra
- All India Institute of Medical Sciences, Department of Forensic Medicine and Toxicology, Patna, Bihar, India
| | - Shashank Ranjan
- All India Institute of Medical Sciences, Department of Forensic Medicine and Toxicology, Patna, Bihar, India
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2
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Banisefid E, Baghernezhad K, Beheshti R, Hamzehzadeh S, Nemati S, Samadifar Z, Owaysee Osquee H, Javanshir E, Naseri A. Cardiac hydatid disease; a systematic review. BMC Infect Dis 2023; 23:600. [PMID: 37705012 PMCID: PMC10500901 DOI: 10.1186/s12879-023-08576-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 08/29/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Human cystic echinococcosis (CE), is a common health problem in low- and middle-income countries. Cardiac involvement is a relatively rare manifestation of Echinococcus infection. This study aims to summarize the evidence regarding the features of cardiac CE. METHODS Case series of the patients with cardiac CE, were included in this study. Non-English papers, case reports, reviews, letters, , commentaries, and conference abstracts were not included. A systematic search was conducted in PubMed and EMBASE databases and the risk of bias in the included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. RESULTS Out of 3985 results of the searches, finally 37 studies were included in this systematic review. Based on available evidence, cardiac involvement is an uncommon but serious presentation of CE which presents with some non-specific signs and symptoms. Dyspnea, chest pain, and palpitation are the most common symptoms of the disease and normal sinus rhythm is the most common Electrocardiogram (ECG) feature. The disease is not associated with high mortality in case of timely diagnosis and appropriate management. DISCUSSION Consecutive and complete inclusion of participants, statistical analysis, and appropriate reporting of the demographics were the sources of bias in the included studies. The exclusion of non-English papers was a limitation during the review process. FUNDING The research protocol was approved and supported by the Student Research Committee, Tabriz University of Medical Sciences (grant number: 69380). REGISTRATION This study was registered in the International prospective register of systematic reviews (PROSPERO ID: CRD42022381204).
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Affiliation(s)
- Erfan Banisefid
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kosar Baghernezhad
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rasa Beheshti
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sina Hamzehzadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Soheil Nemati
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Golgasht Street, Tabriz, East Azerbaijan, 5166/15731, Iran
| | - Zahra Samadifar
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Golgasht Street, Tabriz, East Azerbaijan, 5166/15731, Iran
| | - Hamid Owaysee Osquee
- Department of Infectious Disease, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elnaz Javanshir
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Golgasht Street, Tabriz, East Azerbaijan, 5166/15731, Iran.
| | - Amirreza Naseri
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
- Research Center for Evidence-Based Medicine, Iranian EBM Center: A Joanna Briggs Institute Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran.
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3
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Ahmad Y, Maree G, Omar S, Alkhalaf H. A rare location of cardio hydatid cyst with multiple organ involvement: a case report. Ann Med Surg (Lond) 2023; 85:1220-1222. [PMID: 37113847 PMCID: PMC10129155 DOI: 10.1097/ms9.0000000000000448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/16/2023] [Indexed: 04/29/2023] Open
Abstract
Cardiac cysts in hydatid cysts, a parasitic disease, are extremely rare, and left-atrial hydatid cysts are even more unusual. Therefore, the authors report herein a rare case of a hydatid cyst in the left atrium. According to them, this is the third documented case of left-atrial hydatid cysts. Presentation of Case A 25-year-old male presented at the outpatient clinic with atypical chest pain, hacking cough, dyspnoea, nausea, and vomiting for 2 months. Echocardiography showed a left-atrial unilocular, well-delineated mass. The authors also found multiple liver cysts and spleen cysts. Discussion The widespread distribution of the disease in our regions, the dog contact story of the patient, and the appearance on echocardiograms were strong reasons to diagnose a hydatid cyst in the left atrium, which may cause many symptoms (bundle branch conduction, arrhythmias, myocardial infarction) or unexpected death. Conclusions The authors aimed to report this case due to the disease's high probability of death, even asymptomatic patients with cardiac hydatid disease should all be referred for early surgery.
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Affiliation(s)
- Yara Ahmad
- Faculty of Medicine, Damascus University, Damascus
- Corresponding author. Address: Al-Mazza, Damascus, Syria. Tel: +00963992285436. E-mail address: (Y. Ahmad Ahmad)
| | - Gulan Maree
- Department of Pediatric Surgery, Tishreen University Hospital, Lattakia
| | - Sherawan Omar
- Department of Cardiology, Dil Û Çav Hospital, Al Qamshli, Syria
| | - Hussam Alkhalaf
- Department of Cardiology, Dil Û Çav Hospital, Al Qamshli, Syria
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4
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Denzinger M, Nasir N, Steinkraus K, Michalski C, Hüttner FJ, Traub B. [Treatment concepts for hepatic echinococcosis]. CHIRURGIE (HEIDELBERG, GERMANY) 2023; 94:560-570. [PMID: 36853342 DOI: 10.1007/s00104-023-01825-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
The incidence of both cystic (CE) and alveolar echinococcosis (AE) is increasing in Germany. The CE can often be managed with drug treatment and interventional strategies. In contrast, AE shows characteristics of a malignant disease with a high morbidity and mortality. Benzimidazoles are potent drugs for both entities but with the necessity for a lifelong follow-up and the risk of side effects as well as progression under treatment. Therefore, the indications for surgical resection have to be carefully considered; however, the combination of drug treatment and surgery is the only curative approach. Recently, the use of minimally invasive surgery with reduced morbidity and mortality has justified surgical resection for a broader set of patients; however, minimally invasive surgery requires a high level of expertise and optimal perioperative planning. Therefore, treatment strategies, especially for AE require an individual stratified risk-benefit assessment in an interdisciplinary consensus.
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Affiliation(s)
- Maximilian Denzinger
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Ulm, Albert-Einstein Allee 23, Ulm, Deutschland.
| | - Nadir Nasir
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Ulm, Albert-Einstein Allee 23, Ulm, Deutschland
| | - Kira Steinkraus
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Ulm, Albert-Einstein Allee 23, Ulm, Deutschland
| | - Christoph Michalski
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Ulm, Albert-Einstein Allee 23, Ulm, Deutschland
| | - Felix J Hüttner
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Ulm, Albert-Einstein Allee 23, Ulm, Deutschland
| | - Benno Traub
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Ulm, Albert-Einstein Allee 23, Ulm, Deutschland
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5
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Bajdechi M, Manolache D, Tudor A, Orghidan M, Gurghean A. Cardiac hydatid cysts in a young man: A case report and a literature review. Exp Ther Med 2022; 24:550. [DOI: 10.3892/etm.2022.11487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/31/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Mircea Bajdechi
- Department 1, Medical Semiology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Dalia Manolache
- Department of Pneumology and Thoracic Surgery, ‘Marius Nasta’ Institute of Pneumology, 050159 Bucharest, Romania
| | - Adrian Tudor
- Department of Pneumology and Thoracic Surgery, ‘Marius Nasta’ Institute of Pneumology, 050159 Bucharest, Romania
| | - Mihnea Orghidan
- Department 1, Medical Semiology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Adriana Gurghean
- Department 1, Medical Semiology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
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6
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Nasri S, Aichouni N, Lokman S, Ouafi NE, Kamaoui I, Skiker I. Cardiac hydatid cyst: 2 case reports. Radiol Case Rep 2021; 16:3829-3833. [PMID: 34659601 PMCID: PMC8503848 DOI: 10.1016/j.radcr.2021.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/31/2021] [Accepted: 09/04/2021] [Indexed: 11/28/2022] Open
Abstract
Hydatidosis is a parasitic disease that is still prevalent in regions that rear farm animals, notably along the Mediterranean coast. The liver and lungs are most commonly involved. Cardiac hydatidosis has been reported infrequently even in countries in which hydatid disease is endemic. This entity must be known because when undiagnosed and untreated, the risk of fatal complications increases. We report 2 cases of cardiac echinococcal cysts in young men. The first case is an incidentaloma in a patient admitted for pancreatitis. The second case is about a patient admitted for dyspnea. CT scan and MRI were performed showing intraventrucular cystic mass with a calcified wall which was very suggestive of a hydatid cyst diagnosis. We would like to emphasize the relevance of imaging in this context and shade some light on imaging diagnostic tools.
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Affiliation(s)
- Siham Nasri
- Department of Radiology, Mohammed VI University Hospital, Faculty of Medicine, University Mohammed First, BP 4806 Oujda Universite, Oujda 60049, Morocco
| | - Narjiss Aichouni
- Department of Radiology, Mohammed VI University Hospital, Faculty of Medicine, University Mohammed First, BP 4806 Oujda Universite, Oujda 60049, Morocco
| | - Salma Lokman
- Department of Radiology, Mohammed VI University Hospital, Faculty of Medicine, University Mohammed First, BP 4806 Oujda Universite, Oujda 60049, Morocco
| | - Noha El Ouafi
- Department of Cardiology, Mohammed VI University Hospital, Faculty of Medicine, University Mohammed First, Oujda, Morocco
| | - Imane Kamaoui
- Department of Radiology, Mohammed VI University Hospital, Faculty of Medicine, University Mohammed First, BP 4806 Oujda Universite, Oujda 60049, Morocco
| | - Imane Skiker
- Department of Radiology, Mohammed VI University Hospital, Faculty of Medicine, University Mohammed First, BP 4806 Oujda Universite, Oujda 60049, Morocco
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7
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Dind A, Harmer JA, Hansen PS, Harris B. Extensive pulmonary artery embolisation caused by cardiac hydatid cyst rupture. BMJ Case Rep 2021; 14:14/4/e240521. [PMID: 33827876 PMCID: PMC8030676 DOI: 10.1136/bcr-2020-240521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
This case study is a rare example of cardiac hydatidosis in a high-income country, where a middle-aged man presented with a ruptured right ventricular cyst causing anaphylaxis, pulmonary emboli and dissemination of Echinococcus throughout the lung. He survived the cyst rupture and underwent cardiac surgery but had incomplete resection and experienced progressive cardiopulmonary hydatidosis despite antihelminthic therapy. As a result, he experienced an array of cardiopulmonary sequelae over his lifespan. This case report highlights rare clinical manifestations of hydatid disease and potential complications of its treatment.
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Affiliation(s)
- Ashleigh Dind
- Department of Cardiology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Jason A Harmer
- Department of Cardiology, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Peter S Hansen
- Department of Cardiology, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Benjamin Harris
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Respiratory Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia
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8
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Prasad K, Kumar R, Halder V, Raju M, Negi SL, Naganur S. Multimodality imaging of an interventricular septum hydatid cyst. Egypt Heart J 2021; 73:23. [PMID: 33687569 PMCID: PMC7943659 DOI: 10.1186/s43044-021-00147-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 02/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiac hydatid over the interventricular septum is extremely rare. Echinococcus infests humans as an accidental host. Echocardiography usually clinches the diagnosis of cardiac hydatid. However, multimodality imaging including cardiac magnetic resonance (CMR) imaging, computed tomography (CT), and positron emission tomography (PET) helps in supporting the diagnosis and surgical planning. CASE PRESENTATION We present a 29-year-old male who presented with dyspnea and was found to have cardiac hydatid on the interventricular septum on echocardiography. CT and CMR clinched the diagnosis. CT pulmonary angiography showed extensive pulmonary thromboembolization and cavitary consolidation in lungs. PET showed no active uptake in cardiac hydatid. Post-surgical enucleation of the cyst his hypotension worsened and succumbed. CONCLUSION Cardiac hydatid has poor prognosis. Multimodality imaging helps in confirming the diagnosis and surgical planning.
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Affiliation(s)
- Krishna Prasad
- Department of Cardiology, Advanced Cardiac Centre, PGIMER, Chandigarh, India
| | - Rupesh Kumar
- Department of CVTS, Advanced Cardiac Centre, PGIMER, Chandigarh, India
| | - Vikram Halder
- Department of CVTS, Advanced Cardiac Centre, PGIMER, Chandigarh, India
| | - Muni Raju
- Department of Radiodiagnosis, PGIMER, Chandigarh, India
| | | | - Sanjeev Naganur
- Department of Cardiology, Advanced Cardiac Centre, PGIMER, Chandigarh, India.
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9
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Mir H, McClure A, Thampinathan B, Chow C, Cusimano RJ, Bogoch II, Thavendiranathan P. Echocardiographic Features of Cardiac Echinococcal Infection. CASE (PHILADELPHIA, PA.) 2021; 5:26-32. [PMID: 33644510 PMCID: PMC7887517 DOI: 10.1016/j.case.2020.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cardiac masses are a rare but important finding requiring detailed investigation. Echocardiography is a first-line imaging modality. CT and MRI together allow precise structural and tissue characterization. Surgical removal is a potentially curative treatment for cardiac hydatid cysts.
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Affiliation(s)
- Hassan Mir
- Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada.,Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Andrew McClure
- Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Babitha Thampinathan
- Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Cindy Chow
- Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Robert J Cusimano
- Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Isaac I Bogoch
- Divisions of Infectious Diseases and General Internal Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
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10
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Abstract
Hydatid cyst is a serious parasitic infection in endemic areas. Cardiac hydatid cyst is not a common presentation, and primary pericardial hydatid cyst is rare. Echocardiography, CT, and MRI are important in diagnosing and locating cardiac echinococcosis. Herein, we present the case of an asymptomatic butcher with primary pericardial hydatid cyst and its successful treatment.
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11
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Ibrahim FF, Rubay D, Yi S, Barqawi Z, Abed AN. Surgical Management of Cardiac Hydatid Cyst and the Residual Intramural Ectocyst. Cureus 2020; 12:e9829. [PMID: 32953338 PMCID: PMC7495958 DOI: 10.7759/cureus.9829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The cardiac hydatid cyst (HC) is a rare pathology and mostly is endemic in livestock raising countries. Patients do not have a specific presentation so it is mainly a diagnosis based on imaging. Finding HC anywhere in the body warrants looking for another hydatid in other organs. This is a case report of a young male who presented with nonspecific symptoms and during diagnostic workup, it happened that he has combined hepatic and cardiac HCs. The cardiac cyst was located intramurally in the interventricular septum and expanding down mostly to the left side of the diaphragmatic surface of the heart and partly crossing intramurally to the diaphragmatic surface of the right ventricle. Emergency open-heart surgery was performed; the endocyst was removed while intramural ectocyst was drained to prevent potential future residual space.
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Affiliation(s)
- Firas F Ibrahim
- Cardiac Surgery, Iraqi Center of Heart Diseases, Baghdad, IRQ
| | - David Rubay
- Trauma and Surgical Critical Care, University of Florida College of Medicine, Gainesville, USA
| | - Slee Yi
- Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, USA
| | - Zuhair Barqawi
- Surgery, University of Colorado School of Medicine, Aurora, USA
| | - Ali N Abed
- Cardiac Surgery, Iraqi Center for Heart Diseases/Medical City Teaching Complex, Baghdad, IRQ
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12
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Saeedan MB, Aljohani IM, Alghofaily KA, Loutfi S, Ghosh S. Thoracic hydatid disease: A radiologic review of unusual cases. World J Clin Cases 2020; 8:1203-1212. [PMID: 32337194 PMCID: PMC7176618 DOI: 10.12998/wjcc.v8.i7.1203] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 01/24/2020] [Accepted: 03/22/2020] [Indexed: 02/05/2023] Open
Abstract
Hydatid disease or echinococcosis is a zoonotic parasitic disease. The lung is the second most commonly affected organ after the liver. Intra-thoracic and extra-pulmonary hydatid disease is uncommon and may involve the pleura, mediastinum, heart, diaphragm, and chest wall. Unusual locations or complications of thoracic hydatid disease may pose a diagnostic challenge. We present imaging findings of cases with unusual location and presentations of thoracic hydatid disease with emphasis on their clinical implications.
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Affiliation(s)
- Mnahi Bin Saeedan
- Department of Radiology, King Faisal Specialist Hospital and Research Center, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Ibtisam Musallam Aljohani
- Department of Radiology, King Faisal Specialist Hospital and Research Center, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Khalefa Ali Alghofaily
- Medical Imaging Department, Qassim University, College of Medicine, Buraydah 52571, Saudi Arabia
| | - Shukri Loutfi
- Medical Imaging Department, Chest Radiology Section, King Abdulaziz Medical City, Riyadh 12746, Saudi Arabia
| | - Subha Ghosh
- Imaging Institute, Section of Thoracic Imaging, Cleveland Clinic, Cleveland, OH 44195, United States
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13
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Wadhawa V, Shah J, Doshi C, Ramani J, Lakhia K, Rathod D, Tavar R, Kothari J. Surgical overview of cardiac echinococcosis: a rare entity. Interact Cardiovasc Thorac Surg 2019. [PMID: 29522097 DOI: 10.1093/icvts/ivy053] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The purpose of this study was to describe our experience with the presentation and management of cardiac echinococcosis and the outcomes. METHODS We performed a retrospective study from January 2012 to September 2017 in 10 patients operated on for cardiac echinococcosis. There were 6 men and 4 women; the age range was 17-55 years (mean age, 35.9 ± 12.04 years). Among the 10 patients, 3 had multiple cysts and of the 7 patients with a solitary cyst, 5 cysts were in the left ventricle, 1 was in the right ventricle and 1 was in the interventricular septum. All patients were evaluated with electrocardiography, transthoracic echocardiography, computed tomography/magnetic resonance imaging of the thorax, ultrasound examinations of the abdominal organs, haemagglutination tests and histopathological examination of the cyst. RESULTS Nine operations were performed using cardiopulmonary bypass. One patient with a pericardial cyst was operated on with a beating heart with cystectomy and partial pericardiectomy. Preoperatively, all patients received albendazole for 2 weeks except for 1 patient who had an emergency operation. Albendazole was continued postoperatively in all patients for 12 weeks. There were no postoperative complications. No recurrences have been observed so far. CONCLUSIONS Cardiac echinococcosis is an infrequently encountered entity, but with clinical suspicion and early diagnosis it can be successfully managed with good outcomes.
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Affiliation(s)
- Vivek Wadhawa
- Department of Cardiovascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology and Research Center (Affiliated with B.J. Medical College), Ahmedabad, Gujarat, India
| | - Jigar Shah
- Department of Cardiovascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology and Research Center (Affiliated with B.J. Medical College), Ahmedabad, Gujarat, India
| | - Chirag Doshi
- Department of Cardiovascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology and Research Center (Affiliated with B.J. Medical College), Ahmedabad, Gujarat, India
| | - Jaydip Ramani
- Department of Cardiovascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology and Research Center (Affiliated with B.J. Medical College), Ahmedabad, Gujarat, India
| | - Ketav Lakhia
- Department of Cardiovascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology and Research Center (Affiliated with B.J. Medical College), Ahmedabad, Gujarat, India
| | - Divyesh Rathod
- Department of Cardiovascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology and Research Center (Affiliated with B.J. Medical College), Ahmedabad, Gujarat, India
| | - Reema Tavar
- Department of Anesthesia, U.N. Mehta Institute of Cardiology and Research Center (Affiliated with B.J. Medical College), Ahmedabad, Gujarat, India
| | - Jignesh Kothari
- Department of Cardiovascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology and Research Center (Affiliated with B.J. Medical College), Ahmedabad, Gujarat, India
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14
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Vural U, Aglar AA, Kayacioglu İ. Intracoronary Hydatid Cyst Resulted in Coronary Artery Disease in a Young Patient. Braz J Cardiovasc Surg 2019; 34:107-110. [PMID: 30810684 PMCID: PMC6385834 DOI: 10.21470/1678-9741-2018-0033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 02/21/2018] [Indexed: 11/28/2022] Open
Abstract
Among all cystic echinococcosis cases, only 0.5%-2% exhibit a cardiac
involvement. Only 10% of these become symptomatic. Considering the long time
interval between the start of infestation and symptoms to occur, it is hard to
diagnose cystic echinococcosis. When detected, even if it is asymptomatic,
intramyocardial hydatid cyst requires surgical intervention due to risks of
spontaneous rupture and anaphylaxis. In literature, no case of hydatid cyst
located in the coronary arterial wall has been reported. Twenty-two-year-old
male patient with previous history of pulmonary cystic echinococcosis was
referred to us with typical symptoms of coronary artery disease. Coronary
cineangiography revealed proximal left diagonal artery (LAD) occlusion.
Pre-operative transthoracic echocardiography of the patient planned to undergo
coronary artery bypass grafting unveiled an intracoronary calcified cystic mass.
In operation, the calcified cystic mass with well-defined borders and size of
2x2 cm located within wall of proximal segment of the LAD artery was excised and
double bypass with left internal thoracic artery (LITA) and great saphenous vein
grafts to the LAD and first diagonal arteries, respectively, was done.
Pathological analysis of the mass revealed it to be an inactive calcified
hydatid cyst. Echinococcal IgG-ELISA test was positive. 12-week oral albendazole
treatment (2x400 mg/day) was launched postoperatively and the patient was
discharged on 7th postoperative day.
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Affiliation(s)
- Unsal Vural
- Departament Cardiovascular Surgery, Doktor Siyami Ersek Gogus Kalp ve Damar Cerrahisi Egitim ve Arastirma Hastanesi Ringgold Standard Institution, Istanbul, Turkey
| | - Ahmet Arif Aglar
- Departament Cardiovascular Surgery, Doktor Siyami Ersek Gogus Kalp ve Damar Cerrahisi Egitim ve Arastirma Hastanesi Ringgold Standard Institution, Istanbul, Turkey
| | - İlyas Kayacioglu
- Departament Cardiovascular Surgery, Doktor Siyami Ersek Gogus Kalp ve Damar Cerrahisi Egitim ve Arastirma Hastanesi Ringgold Standard Institution, Istanbul, Turkey
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15
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Tekin AF, Durmaz MS, Dağli M, Akbayrak S, Akbayrak P, Turgut B. Left ventricular hydatid cyst mimicking acute coronary syndrome. Radiol Case Rep 2018; 13:697-701. [PMID: 29682142 PMCID: PMC5909026 DOI: 10.1016/j.radcr.2018.03.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 03/24/2018] [Indexed: 11/07/2022] Open
Abstract
Hydatid disease is caused by the larvae of Echinococcus granulosus. Domestic dogs and cats are the primary carriers of echinococcal organisms. In some particular regions of the world, this parasitic infection is still endemic. Despite the fact that hydatid disease is most frequently located in the liver (50%-70% of cases) and the lungs (20%-30% of cases), it can occur in any organ or tissue. However, intracardiac localization of hydatid cyst is very rare and it is found in less than 2% of the cases. Cardiac involvement can be caused by systemic or pulmonary circulation or direct spread from adjacent structures. After the cardiac hydatid cyst remained asymptomatic for many years, the cyst opens into the pericardium, causes cardiac tamponade, and mimics acute coronary syndrome, or it may get into the circulation and cause anaphylactic shock, which happens rarely. Because clinical signs and symptoms of cardiac hydatid cyst are not specific and varied, it may be difficult to diagnose this disease. It is critical to diagnose cardiac involvement early and perform prompt surgical intervention. Imaging findings of a patient who had a left ventricular wall cardiac hydatid disease are presented here.
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Affiliation(s)
- Ali Fuat Tekin
- Departmant of Radiology, Konya Health Sciences University Teaching and Research Hospital, Necip Fazıl Mahallesi, Fatih Cad. No:4/1, Meram, Konya, 42090, Turkey
| | - Mehmet Sedat Durmaz
- Departmant of Radiology, Konya Health Sciences University Teaching and Research Hospital, Necip Fazıl Mahallesi, Fatih Cad. No:4/1, Meram, Konya, 42090, Turkey
| | - Mustafa Dağli
- Department of Cardiovascular Surgery, Konya Health Sciences University Teaching and Research Hospital, Konya, Turkey
| | - Sahabettin Akbayrak
- Departmant of Radiology, Konya Health Sciences University Teaching and Research Hospital, Necip Fazıl Mahallesi, Fatih Cad. No:4/1, Meram, Konya, 42090, Turkey
| | - Pelin Akbayrak
- Departmant of Cardiology, Konya Health Sciences University Teaching and Research Hospital, Konya, Turkey
| | - Bekir Turgut
- Departmant of Radiology, Konya Health Sciences University Teaching and Research Hospital, Necip Fazıl Mahallesi, Fatih Cad. No:4/1, Meram, Konya, 42090, Turkey
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16
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Ben Khalfallah A, Ben Slima H. [Cardiac hydatid cyst. Which imaging modality for an accurate diagnosis?]. Ann Cardiol Angeiol (Paris) 2017; 66:102-108. [PMID: 28342525 DOI: 10.1016/j.ancard.2016.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 12/21/2016] [Indexed: 11/25/2022]
Abstract
Cardiac echinococcosis is rare. Its spontaneous course is serious because of the risk of rupture. Its clinical manifestations are variable, often latent and misleading. The diagnosis is sometimes referred to by chest radiography. It is much facilitated by non-invasive imaging techniques in particular transesophageal and transthoracic echocardiography, CT scan and magnetic resonance imaging. The latter through a morphological and topographical analysis accurate diagnosis of hydatid cyst and its relationship to cardiac muscle and surrounding tissue. Through functional analysis in cine cyst movements relative to the heart wall, it confirms its free or fixed character in the heart chambers, determines its insertion area, its deformability, the risk of rupture and its impact on myocardial contraction. Our case illustrates the relative contribution of these different imaging techniques and their respective contributions to the identification of hydatid cyst of its wall, its contents, its relationship with the various tunics and heart chambers and its relations with the lungs and mediastinum.
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Affiliation(s)
- A Ben Khalfallah
- Faculté de médecine de Tunis, université de Tunis El Manar, 1007 Tunis, Tunisie; Service de cardiologie, hôpital De Menzel Bourguiba, 7050 Bourguiba, Tunisie.
| | - H Ben Slima
- Faculté de médecine de Tunis, université de Tunis El Manar, 1007 Tunis, Tunisie; Service de cardiologie, hôpital De Menzel Bourguiba, 7050 Bourguiba, Tunisie
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17
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Yasim A, Ustunsoy H, Gokaslan G, Hafız E, Arslanoglu Y. Cardiac Echinococcosis: A Single-Centre Study with 25 Patients. Heart Lung Circ 2017; 26:157-163. [DOI: 10.1016/j.hlc.2016.05.122] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 05/29/2015] [Accepted: 05/26/2016] [Indexed: 10/21/2022]
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18
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Singh A, Sharma R, Garg A, Nanda NC, Elsayed M, Taher A, Bulur S. Usefulness of bubble study in echocardiographic diagnosis of contained rupture of hydatid cyst in the right ventricular outflow tract. Echocardiography 2016; 33:1402-8. [PMID: 27650224 DOI: 10.1111/echo.13317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We describe an adult female presenting with dyspnea in whom both transthoracic and transesophageal echocardiography detected a mobile sac-like structure in the right ventricular outflow tract (RVOT) containing a heterogenous echogenic mass. This sac-like structure markedly changed its shape and size during the cardiac cycle. These findings and the fact that the patient lived in a rural area raised the possibility that this was a hydatid cyst. A bubble study using normal saline was useful in detecting a contained rupture of the cyst. Bubble echoes were noted within the sac-like structure but did not penetrate the inner wall of the cyst which contained echogenic material, indicating that the rupture was confined only to the outer layers. At surgery, a 0.5 cm communication was noted between the cyst and the RVOT and pathology confirmed the diagnosis of hydatid cyst.
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Affiliation(s)
- Amitoj Singh
- Department of Cardiology, St. Luke's University Health Network, Bethlehem, Pennsylvania
| | - Ravindra Sharma
- Santokba Durlabhji Memorial Hospital, Jaipur, Rajasthan, India
| | - Ashok Garg
- Jaipur Heart Institute, Jaipur, Rajasthan, India
| | - Navin C Nanda
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Mahmoud Elsayed
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama
| | - Ahmed Taher
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama
| | - Serkan Bulur
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama
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19
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Jain N, Sethi S, Gupta N, Goel V, Puri SK. Comprehensive Evaluation of Cardiac Hydatid Using 256 Slice Dual Source CT: One Stop Shop. J Clin Diagn Res 2015; 9:TD01-3. [PMID: 26557591 DOI: 10.7860/jcdr/2015/13679.6550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 07/03/2015] [Indexed: 11/24/2022]
Abstract
Hydatid disease results from infection with larval stage of Echinococcus granulosus tapeworm. Dogs and other canines are the definitive hosts; Human beings are common accidental intermediate hosts. Liver is the most common organ to be involved in this condition. Cardiac hydatid, seen in only 0.5 to 2% cases, is a rare entity because of myocardial contractility. Larvae reach the myocardium through coronary circulation. Among various locations of cardiac hydatid, due to its rich coronary arterial supply Left ventricle (LV) myocardium is the most common site of involvement followed by interventricular septum and right ventricle. Rare locations include pericardium, right atrium and left atrium. A 50-year-old woman presented with dyspnoea for 11 months, chest X-ray showed a well defined, homogenous left paracardiac mass, which is not separable from left heart border. Transthoracic echocardiography revealed a complex multicystic mass lesion abutting antero-lateral wall of left ventricle. Contrast enhanced computed tomography showed a well-circumscribed multicystic mass lesion with honeycomb appearance arising from myocardium of anterolateral wall of left ventricle. Indirect haemagglutination test for hydatid disease was positive. At surgery the cyst was seen to arise from LV myocardium. It was incised and grape like contents were evacuated. The cavity was irrigated with scolicidal solution. Thereafter, the cyst was marsupialised. Histopathological examination revealed grape like cyst contents consistent with the diagnosis of hydatid cyst.
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Affiliation(s)
- Neeraj Jain
- Senior Resident, Department of Radiology, G B Pant Hospital , New Delhi, India
| | - Sonali Sethi
- Senior Resident, Department of Radiology, G B Pant Hospital , New Delhi, India
| | - Nishant Gupta
- Senior Resident, Department of Radiology, G B Pant Hospital , New Delhi, India
| | - Vandana Goel
- Assistant Professor, Department of Radiology, G B Pant Hospital , New Delhi, India
| | - Sunil Kumar Puri
- Head and Director Professor, Department of Radiology, G B Pant Hospital , New Delhi, India
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20
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Yildiz CE, Sinan ÜY, Yildiz A, Çetin G, Küçükoğlu S. A Case of Isolated Cardiac Hydatid Cyst that Mimics Lymphoproliferative Malignancy. Echocardiography 2014; 32:1036-9. [PMID: 25470654 DOI: 10.1111/echo.12856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Cardiac cystic echinococcosis is a rare parasitic infestation caused by Echinococcus granulosus larvae and it composes 0.5-2% of all human cystic echinococcosis cases. The left ventricle is the most common affected area followed by right ventricle, interventricular septum, left atrium, right atrium, and interatrial septum. The diagnosis is difficult because of nonspecific clinical and radiographic findings. We present a case of isolated apical cardiac cystic echinococcosis mimicking lymphoproliferative disease.
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Affiliation(s)
- Cenk Eray Yildiz
- Department of Cardiovascular Surgery, Istanbul University Institute of Cardiology, Istanbul, Turkey
| | - Ümit Yaşar Sinan
- Department of Cardiology, Istanbul University Institute of Cardiology, Istanbul, Turkey
| | - Ahmet Yildiz
- Department of Cardiology, Istanbul University Institute of Cardiology, Istanbul, Turkey
| | - Gürkan Çetin
- Department of Cardiovascular Surgery, Istanbul University Institute of Cardiology, Istanbul, Turkey
| | - Serdar Küçükoğlu
- Department of Cardiology, Istanbul University Institute of Cardiology, Istanbul, Turkey
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21
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Sabzi F, Faraji R. Hydatid cyst of the interventricular septum causing complete heart block and postoperative ventricular septal defect. Indian J Crit Care Med 2014; 18:473-5. [PMID: 25097364 PMCID: PMC4118517 DOI: 10.4103/0972-5229.136080] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Cardiac involvement is seen in 0.5-2% of patients with hydatid disease, and involvement of the interventricular septum (IVS) is even rarer. We report surgical treatment of a large cardiac hydatid cyst in the IVS. A 55-year-old woman presented with dyspnea and bradycardia. Transthoracic echocardiography revealed a large cyst in the mid to apical part of the IVS. The patient was placed on cardiopulmonary bypass. Through an incision to bulging part of cyst into right atrium, and without opening adjacent cardiac chambers, we aspirated the entire contents of the cyst, removed its germinative membrane, and washed the cavity with 96% alcoholic solution. The patient recovered uneventfully. She had begun taking albendazole 5 days preoperatively, and this therapy was continued for 12 weeks postoperatively. A permanent pace maker was implanted because she was dependent on temporary pace maker and after 1 year follow-up, complete heart block had not recovered to normal conduction rhythm.
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Affiliation(s)
- Feridoun Sabzi
- Department of Cardiovascular Surgery, Imam Ali Heart Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reza Faraji
- Department of Cardiovascular Surgery, Imam Ali Heart Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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22
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Ward TJ, Jacobi AH, Mendelson DS, Lento PA. AIRP Best Cases in Radiologic-Pathologic Correlation: CardiacEchinococcusInfection. Radiographics 2013; 33:1413-8. [DOI: 10.1148/rg.335125209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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23
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Ibn Elhadj Z, Boukhris M, Kammoun I, Halima AB, Addad F, Kachboura S. Cardiac hydatid cyst revealed by ventricular tachycardia. J Saudi Heart Assoc 2013; 26:47-50. [PMID: 24578600 DOI: 10.1016/j.jsha.2013.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 08/02/2013] [Indexed: 10/26/2022] Open
Abstract
Hydatid disease is a human parasitic infestation caused by the larval stage of Echinococcus Granulosus. The liver and the lungs are the most common locations. Cardiac involvement is rare and accounts for 0.5-2% of all hydatid disease. We report an unusual presentation of cardiac hydatid cyst revealed by ventricular tachycardia in a patient with a history of cerebral hydatid cyst.
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Affiliation(s)
- Zied Ibn Elhadj
- Service de Cardiologie, Hôpital Abderrahmen Mami, Tunis El Manar, 2080 Ariana ; Faculty of Medecine, Tunis El Manar
| | - Marouane Boukhris
- Service de Cardiologie, Hôpital Abderrahmen Mami, Tunis El Manar, 2080 Ariana ; Faculty of Medecine, Tunis El Manar
| | - Ikram Kammoun
- Service de Cardiologie, Hôpital Abderrahmen Mami, Tunis El Manar, 2080 Ariana ; Faculty of Medecine, Tunis El Manar
| | - Afef Ben Halima
- Service de Cardiologie, Hôpital Abderrahmen Mami, Tunis El Manar, 2080 Ariana ; Faculty of Medecine, Tunis El Manar
| | - Faouzi Addad
- Service de Cardiologie, Hôpital Abderrahmen Mami, Tunis El Manar, 2080 Ariana ; Faculty of Medecine, Tunis El Manar
| | - Salem Kachboura
- Service de Cardiologie, Hôpital Abderrahmen Mami, Tunis El Manar, 2080 Ariana ; Faculty of Medecine, Tunis El Manar
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24
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Serraj M, Smahi M, Kamaoui I, El Houari A, Sahnoune F, Ouadnouni Y, Amara B, El Biaze M, Tizniti S, Benjelloun MC. [Hydatic pulmonary embolism: a rare complication of hepatic hydatid cyst]. Rev Mal Respir 2013; 30:215-21. [PMID: 23497931 DOI: 10.1016/j.rmr.2012.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2011] [Accepted: 03/18/2012] [Indexed: 11/17/2022]
Abstract
Hepato-pulmonary hydatidosis is a parasitic disease common in Mediterranean countries. Hydatid pulmonary embolism is extremely rare and is due to rupture of a cardiac hydatid cyst or, more rarely, rupture of a hepatic hydatid cyst. We report three cases of hydatid pulmonary embolism secondary to rupture of a hydatid cyst into the inferior vena cava. Thoracic imaging, mainly CT angiography and MRI, was important for both the diagnosis and decisions on treatment. The prognosis of intra-arterial pulmonary hydatid cyst is poor because of the risk of acute fatal complications such as anaphylactic shock and vascular rupture and also of chronic progression to cor pulmonale and respiratory failure. The therapeutic management is difficult and often only partially effective hence the importance of focusing on preventative treatment.
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Affiliation(s)
- M Serraj
- Service de pneumologie, CHU Hassan II, BP 5552, 30006 Fès Sidi Brahim, Fès, Maroc.
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25
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Abstract
Hydatid cyst is a serious endemic parasitic disease found in cattle-raising areas of the world. Cardiac hydatid cysts are rare and appear in 0.5% to 2% of hydatid cyst cases. A 24-year-old male patient was admitted to the hospital because of chest pain. A cystic mass (4 4 3 cm) was demonstrated with transthoracic echocardiography, computed tomography, and magnetic resonance imaging. A hydatid cyst was located in the right ventricular wall near the inferior branch of the acute marginal branch of the right coronary artery and was located such that it pushed the tricuspid valve inward. The cystic materials were removed with the patient on cardiopulmonary bypass. The surgery for cardiac hydatid disease is safe, and the results are satisfactory.
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Affiliation(s)
- Mehmet Oc
- Department of Cardiovascular Surgery, Selcuk University, Konya, Turkey.
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26
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Díaz-Menéndez M, Pérez-Molina JA, Norman FF, Pérez-Ayala A, Monge-Maillo B, Fuertes PZ, López-Vélez R. Management and outcome of cardiac and endovascular cystic echinococcosis. PLoS Negl Trop Dis 2012; 6:e1437. [PMID: 22235354 PMCID: PMC3250507 DOI: 10.1371/journal.pntd.0001437] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Accepted: 10/30/2011] [Indexed: 12/29/2022] Open
Abstract
Background Cystic echinococcosis (CE) can affect the heart and the vena cava but few cases are reported. Methods A retrospective case series of 11 patients with cardiac and/or endovascular CE, followed-up over a period of 15 years (1995–2009) is reported. Results Main clinical manifestations included thoracic pain or dyspnea, although 2 patients were asymptomatic. Cysts were located mostly in the right atrium and inferior vena cava. Nine patients were previously diagnosed with disseminated CE. Echocardiography was the diagnostic method of choice, although serology, electrocardiogram, chest X-ray, computed tomography/magnetic resonance imaging and histology aided with diagnosis and follow-up. Nine patients underwent cardiac surgery and nine received long-term antiparasitic treatment for a median duration of 25 months (range 4–93 months). One patient died intra-operatively due to cyst rupture and endovascular dissemination. Two patients died 10 and 14 years after diagnosis, due to pulmonary embolism (PE) and cardiac failure, respectively. One patient was lost to follow-up. Patients who had cardiac involvement exclusively did not have complications after surgery and were considered cured. There was only one recurrence requiring a second operation. Patients with vena cava involvement developed PEs and presented multiple complications. Conclusions Cardiovascular CE is associated with a high risk of potentially lethal complications. Clinical manifestations and complications vary according to cyst location. Isolated cardiac CE may be cured after surgery, while endovascular extracardiac involvement is associated with severe chronic complications. CE should be included in the differential diagnosis of cardiovascular disease in patients from endemic areas. Cardiac and vascular involvement are infrequent in classical cystic echinococcosis (CE), but when they occur they tend to present earlier and are associated with complications that may be life threatening. Cardiovascular CE usually requires complex surgery, so in low-income countries the outcome is frequently fatal. This case series describes the characteristics of cardiovascular CE in patients diagnosed and treated at a Tropical Medicine & Clinical Parasitology Center in Spain. A retrospective case series of 11 patients with cardiac and/or endovascular CE, followed-up over a period of 15 years (1995–2009) is reported. The main clinical manifestations included thoracic pain or dyspnea, although 2 patients were asymptomatic. The clinical picture and complications vary according to cyst location. Isolated cardiac CE may be cured after surgery, while endovascular extracardiac involvement is associated with severe chronic complications. CE should be included in the differential diagnosis of cardiovascular disease in patients from endemic areas. CE is a neglected disease and further studies are necessary in order to make more definite management recommendations for this rare and severe form of the disease. The authors propose a general approach based on cyst location: exclusively cardiac, endovascular or both.
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Affiliation(s)
- Marta Díaz-Menéndez
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - José Antonio Pérez-Molina
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Francesca Florence Norman
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Ana Pérez-Ayala
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Begoña Monge-Maillo
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Pilar Zamarrón Fuertes
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Rogelio López-Vélez
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- * E-mail:
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27
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Cece H, Yildiz S, Sogut O, Hazar A, Sezen Y. Isolated Pericardial Hydatid Cyst: A Case Report. Cardiol Res 2011; 2:253-255. [PMID: 28357016 PMCID: PMC5358288 DOI: 10.4021/cr96w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2011] [Indexed: 11/25/2022] Open
Abstract
Cardiac echinococcosis is extremely rare, and cysts are found mostly within the myocardium. Most cardiac hydatid cysts are located in the left ventricular wall. Only a few cases of isolated pericardial hydatid cysts have been reported. Echocardiography, computed tomography and magnetic resonance imaging are important diagnostic tools for the diagnosis of echinococcosis. Herein, we report a rare case of isolated pericardial hydatid cyst who presented to our emergency department with complaints of mid-sternal chest pain and shortness of breath.
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Affiliation(s)
- Hasan Cece
- Harran University, Faculty of Medicine, Department of Radiology, Sanliurfa, Turkey
| | - Sema Yildiz
- Harran University, Faculty of Medicine, Department of Radiology, Sanliurfa, Turkey
| | - Ozgur Sogut
- Harran University, Faculty of Medicine, Department of Emergency Medicine, Sanliurfa, Turkey
| | - Abdussamet Hazar
- Harran University, Faculty of Medicine, Department of Cardiovascular Surgery, Sanliurfa, Turkey
| | - Yusuf Sezen
- Harran University, Faculty of Medicine, Department of Cardiology, Sanliurfa, Turkey
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28
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Ertas F, Duygu H, Acet H, Nazli C, Ergene O. Isolated pericardial hydatidosis as a cause of chest pain. Int J Cardiol 2011; 150:e28-9. [PMID: 19765837 DOI: 10.1016/j.ijcard.2009.08.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2009] [Accepted: 08/20/2009] [Indexed: 10/20/2022]
Abstract
We report a case of isolated pericardial hydatidosis as a cause of chest pain.
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29
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Neuville M, Grisoli D, Nicoud A, Jacquier A, Lagier JC, Collart F, Thomas P, Parola P. Cardiac hydatidosis. Am J Trop Med Hyg 2010; 83:102-3. [PMID: 20595485 DOI: 10.4269/ajtmh.2010.10-0026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We report a case of an adult who developed superior vena cava syndrome because of cardiac hydatidosis. A 37-year-old man from Morocco developed progressive dyspnoea and cough. Cardiac hydatidosis was diagnosed because of both the typical radiological findings and the positive serology for echinococcosis. The patient was treated by surgery and albendazole without complications.
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Affiliation(s)
- Mathilde Neuville
- Service des Maladies Infectieuses et Tropicales, Hôpital Nord, Marseille, France
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30
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Sinha A, Nanda NC, Panwar RB, Kasliwal RR, Chauhan N, Beniwal S, Panwar SR, Khanna D, Bodiwala K, Mehmood F, Upendram S, Vengala S. Live Three-Dimensional Transthoracic Echocardiographic Assessment of Left Ventricular Hydatid Cyst. Echocardiography 2009; 21:699-705. [PMID: 15546370 DOI: 10.1111/j.0742-2822.2004.04005.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
We report an adult patient in whom live three-dimensional transthoracic echocardiography (3DTTE) complemented two-dimensional transthoracic echocardiography (2DTTE) in making a definitive diagnosis of a hydatid cyst located in the left ventricular cavity. The parent hydatid cyst, as well as the daughter cysts, contained within it could be delineated by both 2DTTE and live 3DTTE. However, the tertiary or granddaughter cysts originating from the daughter cysts as well as great-granddaughter cysts budding from tertiary cysts could be visualized only when the live 3DTTE data sets were cropped and sectioned sequentially using multiple cutting planes. In addition, apparent intrinsic mobility of some of the tertiary cysts implying viability was detected only by 3DTTE.
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Affiliation(s)
- Ashish Sinha
- University of Alabama at Birmingham, Division of Cardiovascular Disease, Birmingham, Alabama 35249, USA
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31
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Isolated pericardial and intracardiac hydatidosis: presentation as congestive cardiac failure and fatal pulmonary embolism. Cardiovasc Pathol 2008; 18:114-8. [PMID: 18402821 DOI: 10.1016/j.carpath.2007.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2007] [Revised: 10/22/2007] [Accepted: 11/05/2007] [Indexed: 11/22/2022] Open
Abstract
Localization of hydatid cysts in the heart is a rare phenomenon, with an incidence of 0.5-2%. In almost half these cases, the heart is the sole organ to be involved. We report a case of massive pericardial hydatidosis in a female patient who presented with features of congestive cardiac failure. Cysts in the endocardium of right side of the heart resulted in fatal pulmonary embolism.
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32
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Abstract
OBJECTIVE The purpose of this article is to review the CT and MRI findings of cardiac hydatid disease. CONCLUSIONS 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.
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Karadede A, Alyan O, Sucu M, Karahan Z. Coronary narrowing secondary to compression by pericardial hydatid cyst. Int J Cardiol 2008; 123:204-7. [PMID: 17350701 DOI: 10.1016/j.ijcard.2006.11.174] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2006] [Revised: 11/13/2006] [Accepted: 11/17/2006] [Indexed: 11/20/2022]
Abstract
Echinococcus granulosus remains a clinical problem in undeveloped and developing countries. It commonly affects the liver and lung, but, rarely, other organs such as the heart can be involved. In this report, we describe an unusual case in which pericardial hydatid cyst mimicking acute coronary syndrome secondary to compression by pericardial hydatid cyst attached to the anterolateral wall of the left ventricle. We made diagnosis by transthoracic 2D echocardiography, and confirmed by cardiac magnetic resonance imaging and serologic tests. Because our patient refused to have an operation, albendazole therapy was given. It is important to recognize this unusual disease, because it may lead to serious complications.
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Sirlak M, Ozcinar E, Eren NT, Eryilmaz S, Uysalel A, Enneli D, Ozyurda U. Multiple hydatid cystectomy of the heart necessitating LIMA to LAD anastomosis in a young patient. Cardiovasc Pathol 2007; 18:53-6. [PMID: 18402806 DOI: 10.1016/j.carpath.2007.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2007] [Revised: 08/01/2007] [Accepted: 08/07/2007] [Indexed: 11/28/2022] Open
Abstract
Cardiac hydatid disease is very rare, even in endemic regions. Clinical manifestations included chest pain, anaphylactic shock, constrictive pericarditis, congestive heart failure, and arterial embolism. Surgery is the exclusive therapy, where the cysts are excised during open-heart surgery. The surgical approach therefore must be performed carefully, given the potential complications that surgery may bring. Because of the risk of potentially lethal complications, early diagnosis and definitive treatment are important. A 32-year-old male patient was admitted with chest pain, weight loss, lethargy, and dizziness. On the transesophageal echocardiography study, a cystic mass (2.5 x 3 x 4.5 cm in dimension adjacent to the left ventricular posterior wall) that was divided into two by a septum was noted. Diagnosis of hydatidosis was confirmed with serologic tests (ELISA and indirect immunofluorescence). Echinococcosis, also known as hydatid disease, is common in several regions of the world, for example, the Mediterranean countries, the Middle East, South America, and East Africa. While performing pericystectomy in the anterior left ventricular wall, we noticed that there were three cysts, contrary to the preoperative diagnosis pointing a single one, and it was impossible to effectively complete the procedure without compromising anterosuperiorly displaced left anterior descending artery (LAD). We decided to go on bypass, arrest the heart, and complete the pericystectomy at the cost of injuring LAD and grafting the left internal mammary artery to LAD. Microscopic examination of the cyst showed a germinal layer and an avascular, eosinophilic, chitinous layer that confirmed the diagnosis of hydatid cyst. The patient was discharged on the fifth postoperative day on albendazole medication.
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Affiliation(s)
- Mustafa Sirlak
- Department of Cardiovascular Surgery, Heart Center, University of Ankara School of Medicine, 06340 Ankara, Turkey.
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Tufekcioglu O, Birincioglu CL, Arda K, Fansa I, Saritas A, Karahan M. Echocardiography Findings in 16 Cases of Cardiac Echinococcosis: Proposal for a New Classification System. J Am Soc Echocardiogr 2007; 20:895-904. [PMID: 17617317 DOI: 10.1016/j.echo.2006.12.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2006] [Indexed: 11/30/2022]
Abstract
BACKGROUND Echocardiography is a reliable method for diagnosing cardiac echinococcosis (CE). Currently, there is no echocardiographic classification system for CE, but such a scheme would facilitate diagnosis. This article presents echocardiographic data for 16 cases with CE and outlines a method for echocardiographic classification of CE based on the World Health Organization's ultrasonographic classification of cystic echinococcosis. METHODS We assessed the echocardiographic features of hydatid cysts in 16 patients with CE (9 women and 7 men; mean age, 41 +/- 18.3 years), all of whom underwent cardiac surgery. The proposed classification system identifies 3 types of CE lesions: active (unilocular or multilocular and echolucent, showing double-layered cyst wall and hydatid sand); transitional (shrunken as a result of reduced intracystic pressure, and showing water lily sign); and inactive (completely degenerated contents creating the ball-of-wool sign). Preoperative echocardiographic findings (lesion location, imaging appearance [unilocular/multilocular, solid/semisolid], echocardiographic classification/type, number of lesions) were compared with computed tomographic, intraoperative echocardiographic, surgical, and parasitological findings. RESULTS Preoperative echocardiography revealed 18 hydatid cysts (10 myocardial, 7 pericardial, 1 on the ascending aorta). In all, 10 lesions appeared multilocular, 6 unilocular, and 2 solid. A total of 11 were active, 5 transitional, and 2 inactive. Computed tomography identified 20 lesions total, therefore, two were missed on echocardiography. The preoperative echocardiographic findings correlated well with intraoperative echocardiographic, surgical, and parasitological findings. CONCLUSION The 3 types of CE lesions defined in this proposed classification system feature distinct echocardiographic characteristics. This new system is reliable and practical, and could assist with diagnosis and rapid treatment of CE.
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Affiliation(s)
- Omac Tufekcioglu
- Department of Cardiology, Cardiovascular Surgery, Yuksek Ihtisas Hospital, Ankara, Turkey.
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Oueslati S, Saïd W, Saaidi I, Djebbi M, Charrada L, Rezgui L, Najla M, Châabane M. Imagerie du kyste hydatique du cœur. Presse Med 2006; 35:1162-6. [PMID: 16840892 DOI: 10.1016/s0755-4982(06)74773-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Early diagnosis of cardiac echinococcosis is required because this uncommon disease may lead to serious complications. We report 8 cases of cardiac hydatidosis, review the modes of diagnosis, and stress the contribution of modern imaging techniques. METHODS This retrospective study describes 8 patients with cardiac echinococcosis. All had chest radiographs and thoracic computed tomography (CT). Transthoracic sonography was performed in 6 cases and magnetic resonance imaging (MRI) in 5. RESULTS Our patients ranged in age from 7 to 46 years, and the clinical features of their disease varied. Chest radiography showed the contours of the heart to be deformed in 3 cases and cardiomegaly in 3 others. Echocardiography revealed a homogeneous unilocular hydatid cyst in 5 cases. CT found homogeneous hypodense unilocular lesions in 7 cases, and a septated cyst with cardiac wall calcifications in one case. MRI showed round homogeneous lesions in 3 cases, all dark in T1-weighted sequences and bright in T2. DISCUSSION Clinical features vary substantially, and clinical latency is not uncommon. Chest radiography generally shows mediastinal masses. Transthoracic echocardiography can locate and count cardiac hydatid cysts and identify their borders. CT can simultaneously assess any visceral extension of the disease, while MRI provides details of mediastinal extensions. CONCLUSION Transthoracic echocardiography suggests the initial diagnosis. CT and MRI provide details of the location and extension of the cardiac hydatidosis.
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Affiliation(s)
- Seddik Oueslati
- Service d'imagerie médicale, Hôpital Mahmoud Matri, Ariana, Tunisie.
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Ormeci N, Idilman R, Akyar S, Palabiyikoğlu M, Coban S, Erdem H, Ekiz F. Hydatid cysts in muscle: a modified percutaneous treatment approach. Int J Infect Dis 2006; 11:204-8. [PMID: 16814586 DOI: 10.1016/j.ijid.2005.10.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2005] [Revised: 09/12/2005] [Accepted: 10/12/2005] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Any organ in the human body may be affected by hydatid disease, but the liver and the lungs are most commonly affected. A rare localization of hydatid disease is within muscle tissue. Herein we present three patients with muscular hydatid disease who were successfully treated with a modified percutaneous approach. METHODS Patients with Gharbi type III cysts were treated on an outpatient basis. All procedures were performed under ultrasound guidance in the ultrasonography unit of our department. After local anesthesia, percutaneous puncture was performed in a one-step procedure. After free drainage stopped, absolute ethanol and polidocanol were injected into the cyst cavity. After the procedure, the patient was observed for at least six hours for any adverse reactions and sent home. Patients were followed-up with ultrasonography. A positive treatment effect was characterized by a reduction of the cyst's pseudo-tumor pattern and size, and by detachment of the germinal membrane. RESULTS The three patients in this report had a total of five hydatid cysts in muscle tissue and were all successfully treated with a modified percutaneous approach without recurrence. CONCLUSION Percutaneous drainage without re-aspiration is simple, easy to apply, low cost, repeatable, and does not require hospitalization. There have been no reported deaths associated with the procedure and morbidity is very low. When the technique is applied properly, relapses do not occur. With its low complication rate and its suitability for outpatient treatment, this method can be an alternative to surgery or puncture, aspiration, injection, and re-aspiration (PAIR) in selected patients.
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Affiliation(s)
- Necati Ormeci
- Department of Gastroenterology, Ankara University Medical School, Ibn'i Sina Hospital, Sihhiye, Ankara, 06100 Turkey.
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Pakis I, Akyildiz EU, Karayel F, Turan AA, Senel B, Ozbay M, Cetin G. Sudden death due to an unrecognized cardiac hydatid cyst: three medicolegal autopsy cases. J Forensic Sci 2006; 51:400-2. [PMID: 16566779 DOI: 10.1111/j.1556-4029.2006.00056.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Echinococcosis is a human infection caused by the larval stage of Echinococcocus granulosus. The most common sites of infection are the liver and the lungs. Cardiac hydatid cysts are very rare, even in regions where hydatic cysts are endemic (the Mediterranean, South America, Africa, and Australia). It has been reported that cardiac involvement is seen in about 0.5-3% of human echinococcosis cases. Three cases of cardiac hydatid disease that caused sudden death and which were histopathologically diagnosed are reported. Cardiac echinococcosis is rare, but due to its insidious presentation and affinity to cause sudden death, it is important that it be identified in the histopathological examination.
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Affiliation(s)
- Isil Pakis
- Council of Forensic Medicine, Istanbul, Turkey.
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Vanovermeire OM, Duerinckx AJ, Duncan DA, Russell WG. Caseous calcification of the mitral annulus imaged with 64-slice multidetector CT and magnetic resonance imaging. Int J Cardiovasc Imaging 2006; 22:553-9. [PMID: 16505956 DOI: 10.1007/s10554-005-9069-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2005] [Accepted: 12/15/2005] [Indexed: 11/29/2022]
Abstract
Caseous calcification of the mitral annulus is a rare entity in cardiac imaging. We present CT and magnetic resonance imaging (MRI) in a patient evaluated for severe mitral valve regurgitation with such calcified cardiac mass in the thickened basal wall of the left ventricle. Despite good visualization of the mass both with 64-slice multidetector CT and MRI, the characterization of the lesion was difficult. The most critical finding was the presence of a hyperdense mass with an even denser peripheral rim on pre-contrast CT images. The mass did not enhance after X-ray contrast agent administration. We discuss the preoperative differential for calcified intramyocardial mass.
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Peters PJ, Reinhardt S. The Echocardiographic Evaluation of Intracardiac Masses: A Review. J Am Soc Echocardiogr 2006; 19:230-40. [PMID: 16455432 DOI: 10.1016/j.echo.2005.10.015] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2005] [Indexed: 11/28/2022]
Abstract
Echocardiography is an invaluable procedure for the evaluation of intracardiac masses, and can reliably identify mass location, attachment, shape, size, and mobility, while defining the presence and extent of any consequent hemodynamic derangement. With careful attention to mass location and morphology, and appropriate application of clinical information, echocardiography can usually distinguish between the 3 principal intracardiac masses: tumor, thrombus, and vegetation. Transesophageal imaging frequently adds additional important information to the assessment of mass lesions and should always be considered when image quality is inadequate or pertinent clinical questions remain unanswered with surface imaging. This review will focus on primary and metastatic tumors of the heart.
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Luna A, Ribes R, Caro P, Vida J, Erasmus JJ. Evaluation of cardiac tumors with magnetic resonance imaging. Eur Radiol 2004; 15:1446-55. [PMID: 15627179 DOI: 10.1007/s00330-004-2603-y] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2004] [Revised: 11/16/2004] [Accepted: 11/23/2004] [Indexed: 10/26/2022]
Abstract
Primary cardiac neoplasms are rare, and are more commonly benign than malignant. However, metastases are by far the most common cardiac neoplasms. MRI allows evaluation of myocardial infiltration, pericardial involvement and/or extracardiac extension. MRI overcomes the usual limitations of echocardiography and assesses more accurately changes in cardiac function. Specific tumoral characterization is only possible in cases of myxoma, lipoma, fibroma and hemangioma. Suggestive features of malignancy are right side location, extracardiac extension, inhomogeneity in signal intensity of the tumor and pericardial effusion. The use of intravenous contrast material improves tumor characterization and depiction of tumor borders. MRI also allows differentiation of tumor from other nontumoral masses such as intracavitary tumors or fibromuscular elements of the posterior wall of the right atrium.
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Affiliation(s)
- Antonio Luna
- MR Unit, Clinica Las Nieves, Sercosa, Jaén, Spain.
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