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Diagnosis and treatment of cardiac echinococcosis
  1. Sascha Kahlfuß1,2,
  2. Robert Rainer Flieger1,2,
  3. Torsten Kai Roepke1,2,3,
  4. Kadir Yilmaz1,2
  1. 1HELIOS Clinical Medical Center Köthen, Köthen, Germany
  2. 2Department of Cardiology, HELIOS Clinical Medical Center Köthen, Köthen, Germany
  3. 3Experimental and Clinical Research Center, Charité—Universitätsmedizin Berlin, Berlin, Germany
  1. Correspondence to Dr Sascha Kahlfuß, HELIOS Clinical Medical Center Köthen, Hallesche Str. 29, Köthen 06366, Germany; s.kahlfuss{at}web.de

Abstract

Cardiac echinococcosis is a rare manifestation of cystic echinococcosis (CE) caused by the tapeworm Echinococcus granulosus. Among all patients suffering from CE, only 0.5%–2% exhibit a cardiac involvement. In addition, during the past years the number of CE cases reported in Western Europe remained roughly unchanged. However, we postulate that cases of CE in Western Europe will increase due to a growing number of refugees coming from endemic areas such as Southern Europe, Eastern Europe and the Middle East. Importantly, although cardiac echinococcosis is rare the disease can lead to many clinical complications, for instance acute heart failure and life-threatening arrhythmias. With respect to the increasing relevance of cardiac echinococcosis in Western Europe and the danger of fulminant disease courses, here we review diagnosis strategies and treatment options of the disease. Diagnosis of cardiac echinococcosis requires a detailed evaluation of the patients’ case history, specific laboratory analyses and radiological imaging methods. Ultrasound, MRI and CT are key imaging tools for diagnosis, therapy control, prognosis estimation and disease course control. For the therapy of cardiac echinococcosis, a combination of surgical removal and drug treatment should be applied to symptomatic as well as asymptomatic patients. The complete surgical removal of the cyst(s) is the major prognosis factor of the cardiac manifestation of CE.

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