Article

Echinococcal disease of the right heart diagnosed by transoesophageal echocardiography

January 1998

Authors:

Lampros K Michalis

University of Ioannina

Show all 6 authorsHide

Cardiac echinococcosis is a rare manifestation of echinococcal disease. We discuss a case of cardiac echinococcosis with multiple monolocular hydatid cysts in the right heart and pulmonary artery, who survived recurrent pulmonary emboli and cyst rupture and was successfully operated on. Cardiac echinococcosis in this case was diagnosed using TEE. Previous investigators bad shown the value and the restrictions of TTE in the diagnosis of the disease. TEE proved, in our case, to be a superior method in the diagnosis of the disease.

ResearchGate has not been able to resolve any citations for this publication.

ResearchGate has not been able to resolve any references for this publication.

Article

Isolated pericardial echinococcosis: Perioperative transesophageal echocardiographic evaluation

June 2013 · Journal of Cardiovascular Disease Research

Hydatid cyst (HC) is a human parasitic disease caused by the larval stage of Echinococcus granulosus. Cardiac involvement is rare and occurs in 0.5%-2% of patients with hydatid cyst, but isolated pericardial hydatid cyst is rarer still. We present two cases of isolated pericardial hydatid cyst who presented with precordial chest pain and dyspnea. In both the cases, HC were diagnosed by ... [Show full abstract] transthoracic echo (TTE), Computed Tomography/Magnetic Resonance and positive hydatid serology. Intraoperatively transesophageal echo (TEE) revealed unilocular transitional cystic lesion the transverse pericardial sinus in one case and multilobulated active cystic lesion in another. The report highlights the role of TEE in diagnosis and evaluation of cardiac HC. Both the cases underwent surgical resection followed by albendazole therapy to prevent recurrence.

Article

Echinococcosis of the heart: Clinical and echocardiographic features in 12 patients

March 2005 · Acta Cardiologica

Unlabelled: We describe the clinical and echocardiographic features in 12 patients with hydatid cyst of the heart who were screened between 1985 and 2001. Presenting symptoms have a wide variability but the main symptom was precordial pain. The electrocardiogram was always abnormal and showed T wave inversion in 8 cases, ST depression in 5 cases, incomplete right bundle-branch block in one case ... [Show full abstract] and atrial fibrillation in one case. Transthoracic echocardiography and transoesophageal echocardiography constitute the imaging procedure of choice for the diagnosis of cardiac hydatid cyst with a high sensibility, specificity. Computed tomography (CT) was performed in all patients and confirmed the echocardiographic data. MRI was performed in one patient with right atrium hydatid cyst location and confirmed the echocardiographic data. Conclusion: In the presence of atypical symptomatology in a patient coming from an endemic area of hydatid cyst, the diagnosis of cardiac echinococcosis is possible.TTE and TEE are the imaging procedure of choice and sufficient for the diagnosis of cardiac hydatid cyst. CT and/or MRI provide more information about the extension of echinococcus disease in other intra- or extrathoracic locations.

Article

Value of transesophageal echocardiography in the diagnosis of compressive, atypically located perica...

March 2002 · Journal of the American Society of Echocardiography

Pericardial cysts are not common and rarely cause symptoms. We report 2 cases of atypically located pericardial cysts with hemodynamic compromise because of the direct compression of the pulmonary veins and the right pulmonary artery. In the first case, transesophageal echocardiography (TEE) disclosed a round cystic mass compressing the posterior wall of the right pulmonary artery, with blood ... [Show full abstract] flow reduction in the right lung. Because of the symptoms, the pericardial cyst was drained and the patient had an uneventful 1-year follow-up. In the second case, a large cystic mass compressing the left atrium and the pulmonary vein outflow was clearly shown by TEE in a patient with severe respiratory distress, cyanosis, and low blood pressure. A left ventricular thoracotomy was performed with the drainage of 500 mL serous fluid from the cyst.

Chapter

Cardiac Assessment with 2-D Transesophageal Echocardiography

January 1986

Michael K. Cahalan

Traditional methods of monitoring cardiac function have significant disadvantages. Assessing blood pressure and heart rate provides limited indication of impending circulatory instability. Monitoring the electrocardiogramm does not ensure detection of myocardial ischemia [1, 2]. Although invasive monitoring provides a more sensitive guide, it is associated with potentially fatal complications ... [Show full abstract] such as dysrhythmias and pulmonary artery rupture [3]. In intubated patients, use of 2-D TEE (two-dimensional transesophageal echocardiography) should have advantages over customary monitoring systems: it is potentially safer than invasive techniques, allows direct assessment of left ventricular filling and wall motion, and produces high resolution images even in the presence of extensive lung disease of chest wall deformities when transthoracic echocardiography may not be usable. In this paper, I will describe the technique and clinical application of 2-D transesophageal echocardiography.

Article

Cardiac hydatid cysts: Echocardiographic findings

May 2005 · Journal of Clinical Ultrasound

Cardiac hydatid disease is rare. Many patients are asymptomatic, hence cardiac involvement is often discovered incidentally. Diagnosis is also difficult because of a long period between parasitic infection and the manifestation of disease. Rupture of a cardiac cyst is a serious complication. Diagnosis of cardiac hydatid cysts is often made using transthoracic echocardiography (TTE) and ... [Show full abstract] transesophageal echocardiography (TEE) provides details of the cysts. We present the cases of 3 patients with nonspecific symptoms of their endemic parasitic disease. The results of sonographic examinations in all patients strongly suggested the presence of cardiac hydatid cysts. One patient had a cyst in the external surface of the left ventricular apical-lateral wall visualized with TTE and TEE. Parasitic serology was negative. She underwent surgery, which confirmed a cyst located in the pericardium, and then was treated with albendazole. Another patient had a cyst in the left ventricle demonstrated by TTE and TEE and confirmed with serology. Color Doppler sonography verified that her cardiac cyst was in communication with the left ventricle. She was not a surgical candidate and was treated with albendazole. The final patient had a septated cyst in the media basilar portion of the interventricular septum demonstrated using TTE, and CT. He refused surgical treatment and albendazole was prescribed. Chest radiographs in 3 patients failed to show the cysts, and serology in 1 patient failed to indicate a hydatid cyst. Follow-up at 1-2 years revealed no recurrence in any patient. In all 3 cases, cysts could be visualized from the subcostal view via echocardiography. Imaging is critical for the early diagnosis, assessment, and follow-up of patients with this disease.

Article

Cardiac echinococcosis: recurrent intramyocardial-extracardiac hydatid cysts with pericardial protru...

September 2008 · Circulation Journal

A 26-year-old male patient was diagnosed with an isolated recurrent intramyocardial-extracardiac hydatid cyst with pericardial protrusion after being admitted with chest pain and palpitation. He had undergone surgical resection of an intramyocardial pericardial hydatid cyst without cardiopulmonary bypass 10 years earlier. In the current admission, the results from transthoracic and ... [Show full abstract] transesophageal echocardiography and multislice computed tomography were confirmed by serological and histopathological tests. The cyst was excised under cardiopulmonary bypass, and the patient was treated postoperatively with albendazole for 9 months. His clinical status improved postoperatively and he was asymptomatic without signs of recurrence as determined by echocardiography.

Article

Response to letter by Ling et al.: Surgical extraction of a large left ventricular hydatid cyst unde...

November 2014 · International Journal of Cardiology

Article

Cardiac hydatid cyst (report of 8 cases)

December 2001 · La Tunisie médicale

Hydatic cardiac cyst (HCC) is a rare anomaly, characterized by wide spectrum of clinical presentations. Its diagnosis took large benefit from echocardiography progress. We aimed in this study to analyse epidemiologic aspect of HCC, as well as its diagnostic data, with special emphasize on echocardiography. Observations of 8 patients, admitted between 1991 and 2000 has been reviewed. Age average ... [Show full abstract] was 30 years (13 to 59). Main symptoms consisted of chest pain (62.5%) and dyspnea (35%). Chest X-Rays showed cardiac silhouette anomaly in 4 cases. Electrocardiogram showed sub-epicardical ischemia in 5 patients. HCC diagnosis was established by transthoracic echocardiography in all cases. It was located inside a cardiac chambers (n = 5), the interventricular septum (n = 2), and the pericardium (n = 1). HCC relation with adjacent cardiac structures was well defined by transoesophageal echocardiography performed in 7 cases. All patients underwent surgery with good immediate results. All patients were events free, with a mean follow-up of 25 months.

Article

[Cardiopericardial echinococcosis]

April 2003 · Revue medicale de la Suisse romande

Unlabelled: Cardiac hydatid cysts are rare and represent 0.5 to 2% off all hydatid cyst in human. We describe clinical and echographic features in 12 patients with cardiac echinococcosis, admitted between 1992 and 2001. Average age was 40 years (16-60 years). The cysts were located in the left ventricle wall (3 patients), right ventricle wall (3 patients) right atrium (3 patients) and ... [Show full abstract] pericardial cavity (3 patients). Cardiac Hydatid cyst diagnosis was established by transthoracic echocardiography (TTE) and transoesophageal echocardiography (TEE) in all cases. Computed tomography and magnetic resonance imaging confirmed echographic finding. All patients were operated. The operation finding confirmed the imaging data. Only one patient died in the post operative period. No recurrence or associated complication were reported in the late follow up. Conclusion: In presence of atypical symptomatology in a patient coming from an endemic area of hydatid cyst the diagnosis of cardiac echinococcosis is possible. TTE and TEE are the imaging procedure of choice and sufficient for the diagnosis of cardiac hydatid cyst. CT and/or MRI provide more information about the extension of echinococcosis diseases in other intra or extrathoracic location.

Article

Multicavitated left atrial myxoma mimicking a hydatid cyst

July 2005 · European Heart Journal – Cardiovascular Imaging

A 67 year-old asymptomatic patient was referred to our echo-lab because of hypertension. Transthoracic 2D-echocardiogram showed a non-prolapsing ovoid mass attached to the left side of the interatrial septum. Transesophageal echocardiography evidenced an ovoid cavitated mass with internal areas of calcification. Color Doppler revealed flow inside the cavities. At surgery, a multicavitated mass ... [Show full abstract] was observed attached to interatrial septum. Macroscopically revealed cavities filled with blood, as well as partially calcified areas. Microscopically there were collections of “lipidic” cells embedded in the myxoid matrix, typical of cardiac myxoma. Cardiac hydatid cysts usually have a rounded shape. Most myxomas are solid masses without a cystic architecture or cavitations. Calcification is usually identified at a microscopic level. The combination of a polycystic appearance of the mass and macroscopic areas of calcification is more frequently observed in hydatid cysts than in cardiac myxomas. This appearance of the mass leads us to consider a cardiac echinococcal cyst as the first diagnostic possibility. This peculiar structure of cardiac myxoma, to the best of our knowledge, has never been documented. Transthoracic echocardiography and particularly transesophageal imaging, enable us to delineate this kind of tumors. Surgical resection is the appropriate treatment for these tumors, even in asymptomatic patients.

Article

Color Doppler Transesophageal Echocardiography in Detection of Massive Pulmonary Embolism: Is Pulmon...

December 1996 · Echocardiography

In this article, the potential value of color Doppler in improving diagnostic accuracy of transesophageal echocardiography (TEE) in patients with incomplete obstruction of large pulmonary vessels is illustrated. We present an unusual case of massive pulmonary embolism that was unequivocally detected by color Doppler TEE both before and after pulmonary angiography, which failed to demonstrate ... [Show full abstract] filling defects in the pulmonary artery. (ECHOCARDIOGRAPHY, Volume 13, November 1996)

Article

Sizing the aortic annulus

July 2012 · Annals of Cardiothoracic Surgery

Transcatheter aortic valve implantation (TAVI) is a valuable alternative for aortic valve replacement in selected high-risk candidates. Accurate preoperative assessment of the aortic annular dimensions is crucial for the success of TAVI, since choice of an incorrectly sized prosthesis may result in catastrophic complications. These complications include annular rupture and coronary arterial ... [Show full abstract] obstruction, if the prosthesis is too big, or prosthesis migration and severe paravalvular leakage, if the prosthesis is too small. According to current recommendations, the choice of prosthesis size is based on transoesophageal echocardiography (TEE) measurements. However, TEE results are dependent on operator experience. Moreover, recent research has shown that TEE can significantly underestimate annular dimensional measurements. Alternative sizing methods based on Multidetector Computed Tomography (MDCT) or manometry during balloon aortic valvuloplasty have therefore been developed. We present a brief overview of the imaging modalities available for preoperative assessment of annular size and discuss their potential advantages and limitations.