Hydatid Cyst of the Heart

International Journal of Medical Science and Current Research (IJMSCR)

Available online at: www.ijmscr.com

Volume2, Issue 1,Page No: 272-278

January-February 2019

Hydatid Cyst of the Heart

Dr Sajad Ahmad Bhat, Assistant Professor, Department of Biochemistry, West Kazakhastan Marat Ospanov State Medical University,Aktobe Kazakhstan

Dr Raisa Aringazina , Associate professor, Department of Internal Diseases, West Kazakhastan Marat Ospanov State Medical University,Aktobe Kazakhstan

Dr Rustem Isaev, Chief Doctor of Aktobe Medical Center Aktobe Kazakhstan Dr Ardak Esengulova, Director Hospital of Aktobe Medical Center Kazakhstan

Dr Anes Bekkuzhin, Associate рrofessor, Department of Biochemistry, West Kazakhastan Marat Ospanov State Medical University,Aktobe Kazakhstan

Gulsana Bekbergenova, Doctor of ultrasound diagnostics of Aktobe Medical Center Kazakhstan

Makhmutsultangali Otessin, Student of the faculty of General medicine, West Kazakhastan Marat Ospanov State Medical University,Aktobe Kazakhstan

*Corresponding Author:

Dr Raisa Aringazina

Associate Professor Department of Internal Diseases West Kazakhastan Marat Ospanov State Medical University

Aktobe Kazakhstan

Type of Publication: Case Report Conflicts of Interest: Nil

ABSTRACT

The article describes a clinical case of echinococcal heart cyst in a 37-year-old woman who was hospitalized in the Department of cardiology Aktobe medical center due to cardiac arrhythmia with a first stage heart failure clinically and was successfully operated in a cardiac surgery department. With the help of echocardiography (Echocardiography), the primary isolated echinococcal cyst of the left ventricle of the heart was diagnosed. Echinococcosis is a serious health problem in some endemic geographical regions of the world. Hydatid cyst of heart is uncommon. An important issue is early diagnosis and complex therapy. Surgical treatment of cardiac echinococcosis is better than conservative therapy. Therefore, surgical removal of the left ventricular echinococcal cyst was performed. Cyst extraction in the postoperative period in combination with chemotherapy prevented the risk of recurrence.

Keywords: Echinococcosis of the heart, hydatid cyst, left ventricle, parasites, diagnosis, treatment

INTRODUCTION

Echinococcosis is a parasitic invasion by the larval stage of the ribbon helminthes of Echinococcus, which occurs with the defeat of internal organs (liver, lungs, heart and brain) and the formation of echinococcal cysts in them. Pathology occurs in the territory of the Commonwealth of Independent States (CIS), where livestock - Kazakhstan, Kyrgyzstan, Uzbekistan, Russian Federation. In the world, the incidence of echinococcosis occurs with different

India, Pakistan, Iran, Iraq and some European countries [1,2,3,4,5,6,7,8,9]. Echinococcosis of the heart is extremely rare, only in 0.5-2% of patients [4, 9, 10]. In endemic regions, the incidence of the population can reach up to 5-10%. The primary isolated form of cardiac echinococcosis is about 0.45% [10]. According to WHO, infectious and parasitic diseases remain the leading causes of human

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considered with livestock. But recently there has been a tendency of the disease growth among the urban population, which is not engaged in

agricultural work [18]. The relevance of

echinococcosis of the heart in comparison with its localization in other organs is associated with a rare occurrence. Echinococcus in left ventricle was observed for the first time in the Aktobe region of west Kazakhstan.

Case report

The 37-year-old patient was admitted to the cardiology Department of medical center aktobe with complaints of heart failure, breathlessness & weakness. From the anamnesis of the disease it was found that the periodic heartbeat became worried for a year, did not know the reason. However, two months before admission to the hospital patient complaint of dyspnea 13.06.16 g about 21.00 PM the

condition suddenly deteriorated, due to the

appearance of ventricular tachycardia on the electrocardiogram (ECG) (figure. 1), at the first aid stage 100mg lidocaine was used in/in bolus, then

4mg fractional. Paroxysm docked to sinus

tachycardia (Fig. 2).

Physical examination: When the patient was admitted in the hospital, patient was conscious, skin was clear.

tests were normal except erythrocyte sedimentation

rate (ESR 25-33 mm/h). Enzyme-linked

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Figure 1.ECG (13.06.16) on stage ambulance paroxysmal ventricular tachycardia with heart rate 200 beats per minute.

Figure 2

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Figure 3

ECG (14.06.16): Sinus rhythm 74 beats per minute, normal EOS position, violation of blood supply to the lower left ventricular wall.

Figure 4;5

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Figure 6

Daily ECG monitoring(14.06.16): basic sinus rhythm with heart rate 75 per minute, minimum heart rate 50 per minute, 01:41:39 h, maximum heart rate 126 per minute 18:56: 24 h (there was physical activity). Maximum pause-1.48 seconds, 01:41: 33h, due to sinus arrhythmia. Pauses more than 2 seconds no. During the period of ECG monitoring 247 polymorphic, single ventricular extrasystoles, 1B night hours, 3-supraventricular

extrasystoles were registered. There was no arrhythmia or conduction.

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occur from systemic or pulmonary circulation or as spread from adjacent organs [4, 11, 18]. The absence of a long-term clinical manifestation of ES is associated, echinococcal cysts grow slowly, on average, by 1-3 cm per year.

Analysis of the literature of observations shows [4, 11, 19, 20] that hydatid cysts of the heart are rare and often reaches a large size, rarely — plural. As for the localization of Echinococcus in the heart, it should be noted that there is not a single area of the heart that is not affected by echinococcosis. The most common cysts are located in the muscle of the left (LV) and right ventricles (RV), interventricular septum (MWP), rarely — in the atrium and pericardium. The most frequent localization of echinococcal cysts in the left ventricle and interventricular septum is associated with good blood supply [8]. Transthoracic

echocardiography, computed tomography and

magnetic resonance imaging are the most important tools for patient diagnosis and observation, and serological reactions provide good information about the disease [4,9,12,13,14].In the treatment of hydatid cysts of the heart must be surgical, with a combination of chemotherapy, in the case of isolated cardiac hydatid cyst before surgery is impossible – anthelmintic therapy because of the risk of development of the destruction of the wall of the cyst [4,15,16,17].

In the literature there is a description [11] of the history of the disease similar to the clinical symptom, the use of antiarrhythmic drug for relief of ventricular tachycardia with our observation, but the distinctive features are age (57 years), sex (male) localization in the right ventricle.If there are patients with myocardial and pericardial diseases of unknown cause for endemic regions, in differential diagnosis

recurrence of invasion.In addition, the result of surgical treatment is considered to be very important. Therefore, the treatment of ES should be combined surgical treatment with chemotherapy in the postoperative period in order to prevent relapses.

Echocardiography and serological test for

Echinococcus are the main methods in both diagnosis and control of ES recurrence.

The conclusion of our article is that in cystic lesions

of organs, regardless of their localization,

echinococcosis should be taken into account in the differential diagnosis.

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