[Surgical treatment of acute pericardial tamponade in an infestation of the heart by Echinococcus].
METHODS
A 56-year-old turkish patient, previously in good health, was admitted because of pain suggesting myocardial infarction. Physical examination of the heart, lungs and abdomen was unremarkable.


METHODS
The concentrations of myocardium-specific enzymes were not elevated and the ECG showed no signs of ischaemia. Echocardiography and magnetic resonance imaging ruled out acute aortic dissection, but demonstrated a round cystic space-occupying mass over the anterior wall of the heart. Hydatid cyst was suspected from the imaging results and the patient's origin from area endemic for Echinococcus. The diagnosis was confirmed by a titre of 1:6,400 (normal: 1: < 100) for Echinococcus antibodies.


METHODS
Albendazole administration was initiated. Planned elective surgical removal of the hysatid cyst had to be performed urgently because of acute pericardial tamponade. Cyst rupture was suspected but an actually undamaged cyst was subtotally removed under cardiopulmonary bypass. The postoperative course was uneventful and albendazole treatment was continued.


CONCLUSIONS
Because of the high incidence of fatal complications urgent surgical removal under cardiopulmonary bypass is the treatment of choice for hydatid cyst involving the heart. Perioperative albendazole administration is also essential.
Vicol
C
C
Herzchirurgische Klinik, Zentralklinikum Augsburg.
Rupp
G
G
Wagner
T
T
Sumer
C
C
Höpfner
W
W
Struck
E
E
D000208:Acute Disease; D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D000909:Antibodies, Helminth / Q000097:blood; D002305:Cardiac Tamponade / Q000209:etiology / Q000601:surgery*; D004443:Echinococcosis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D004446:Echinococcus / Q000276:immunology; D005858:Germany; D006331:Heart Diseases / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000150:complications / Q000209:etiology* / Q000601:surgery; D014421:Turkey / Q000208:ethnology
D000871:Anthelmintics; D000909:Antibodies, Helminth; D015766:Albendazole
Chirurgische Behandlung der akuten Perikardtamponade bei Echinokokkusbefall des Herzens.