title: Cardiac manifestations of parasitic diseases.
abstract: The heart may be affected directly or indirectly by a variety of protozoa and helminths. This involvement may manifest in different ways, but the syndromes resulting from impairment of the myocardium and pericardium are the most frequent. The myocardium may be invaded by parasites that trigger local inflammatory response with subsequent myocarditis or cardiomyopathy, as occurs in Chagas disease, African trypanosomiasis, toxoplasmosis, trichinellosis and infection with free-living amoebae. In amoebiasis and echinococcosis, the pericardium is the structure most frequently involved with consequent pericardial effusion, acute pericarditis, cardiac tamponade or constrictive pericarditis. Chronic hypereosinophilia due to helminth infections, especially filarial infections, has been associated with the development of tropical endomyocardial fibrosis, a severe form of restrictive cardiomyopathy. Schistosomiasis-associated lung vasculature involvement may cause pulmonary hypertension (PH) andcor pulmonaleTropical pulmonary eosinophilia, which is characterised by progressive interstitial fibrosis and restrictive lung disease, may lead to PH and its consequences may occur in the course of filarial infections. Intracardiac rupture of anEchinococcuscyst can cause membrane or secondary cysts embolisation to the lungs or organs supplied by the systemic circulation. Although unusual causes of cardiac disease outside the endemic areas, heart involvement by parasites should be considered in the differential diagnosis especially of myocardial and/or pericardial diseases of unknown aetiology in both immunocompetent and immunocompromised individuals. In this review, we updated and summarised the current knowledge on the major heart diseases caused by protozoan and metazoan parasites, which either involve the heart directly or otherwise influence the heart adversely.
authors.affiliation: Hospital das Clinicas, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil mcarmo@waymail.com.br.
authors.forename: Maria Carmo P
authors.initials: MC
authors.lastname: Nunes
authors.affiliation: Hospital das Clinicas, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Milton Henriques
authors.initials: MH
authors.lastname: Guimarães Júnior
authors.affiliation: Hospital das Clinicas, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Adriana Costa
authors.initials: AC
authors.lastname: Diamantino
authors.affiliation: Hospital das Clinicas, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Claudio Leo
authors.initials: CL
authors.lastname: Gelape
authors.affiliation: Hospital das Clinicas, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Teresa Cristina Abreu
authors.initials: TC
authors.lastname: Ferrari
mesh_terms: D001706:Biopsy; D002598:Chagas Cardiomyopathy / Q000175:diagnosis / Q000469:parasitology / Q000503:physiopathology / Q000628:therapy; D003937:Diagnosis, Differential; D004452:Echocardiography; D004719:Endomyocardial Fibrosis / Q000175:diagnosis / Q000469:parasitology / Q000503:physiopathology / Q000628:therapy; D006321:Heart / Q000469:parasitology* / Q000503:physiopathology; D006331:Heart Diseases / Q000175:diagnosis / Q000469:parasitology* / Q000503:physiopathology / Q000628:therapy; D006790:Host-Parasite Interactions; D006801:Humans; D007896:Leishmaniasis / Q000175:diagnosis / Q000469:parasitology* / Q000503:physiopathology / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D012552:Schistosomiasis / Q000175:diagnosis / Q000469:parasitology* / Q000503:physiopathology / Q000628:therapy; D014353:Trypanosomiasis, African / Q000175:diagnosis / Q000469:parasitology* / Q000503:physiopathology / Q000628:therapy
keywords: Chagas disease; Echocardiography; Secondary pulmonary hypertension