Parasitic (Helminthic) cardiomyopathy: A review and pooled analysis of pathophysiology, diagnosis and clinical management

Abstract

Neglected tropical diseases form an important component of the burden of cardiac disease in resource-constrained countries. Some diseases resulting from infection by helminthic parasites such as endomyocardial fibrosis, schistosomiasis and hookworm infections are part of the neglected tropical diseases. The neglect has contributed to the under-appreciation and under-research of helminthic cardiac diseases. In contrast, infections by helminthic parasites are prevalent in resource-constrained countries and are among the leading aetiology of cardiac diseases including cardiomyopathy often associated with an ominous prognosis. Infection by a wide variety of helminth parasites, more commonly Trichinella, Taenia solium, Echinococcus, Schistosoma, Toxocara and Ascaris, and less commonly, Heterophyes, Paragonimus, Strongyloides and Dirofilaria Immitis can result in myocardial injury ultimately progressing to cardiomyopathy. However, data on epidemiology, presentation, diagnosis and management of helminthic cardiomyopathy are few and disparate effectively undermining exact understanding. Moreover, expert guidelines specific to the diagnosis and management of helminthic cardiac diseases are also conspicuously lacking. Current clinical practices on management of helminthic cardiomyopathy appear to depend on health centre experience. This paper aims to provide a broadened view of the clinical status of helminthic cardiomyopathy by reviewing published evidence with a particular focus on the causative helminthic parasites, pathophysiology, diagnosis and clinical management.

Pericardite Constritiva Importante em Paciente com Esquistossomose: Relato de Caso

“…O envolvimento miocárdico ou pericárdico por espécies de Schistosoma é raro e pode ocorrer devido ao acúmulo de ovos de Schistosoma, que induzem uma resposta granulomatosa local. 6 No único caso publicado na literatura médica, 3 o estudo histopatológico do pericárdio mostrou espessamento fibroso com aumento do tecido conjuntivo e identificou a presença de ovos do Schistosoma haematobium. No nosso caso, o estudo anatomopatológico de fragmentos do pericárdio mostrou tecido fibroconjuntivo exibindo extensa calcificação distrófica, contudo não identificou ovos do Schistosoma mansoni.…”

Important Constrictive Pericarditis in a Patient with Schistosomiasis: A Case Report

“…The myocardial and pericardial involvement of SM species is rare and can occur due to the accumulation of SM eggs, which induce a local granulomatous response. 6 In the only case published in the medical literature, 3 the histopathological study of the pericardium showed a fibrous thickening with an increase in the connective tissue and identified the presence of Schistosoma haematobium eggs. In the present case, the anatomopathological study of pericardial fragments showed fibrous connective tissue, showing extensive dystrophic calcification, but no SM eggs were identified.…”

Investigating the effect of the nitric oxide donor L-arginine on albendazole efficacy in Trichinella spiralis-induced myositis and myocarditis in mice

“…Larvae of T. spiralis are unable to encyst in other types of cells including myocardial muscle cells. The cardiac pathology during trichinosis is due to the anti-Trichinella immune response that results in eosinophilic myocarditis [4] .…”