Cardiac hydatid cyst revealed by ventricular tachycardia

Hydatid disease is a human parasitic infestation caused by the larval stage of Echinococcus Granulosus. The liver and the lungs are the most common locations. Cardiac involvement is rare and accounts for 0.5-2% of all hydatid disease. We report an unusual presentation of cardiac hydatid cyst revealed by ventricular tachycardia in a patient with a history of cerebral hydatid cyst

[Evaluation of left ventricular function by systolic time intervals]

Evaluation of left ventricular systolic function, usually based on the assessment of the ejection fraction, is increasingly supplemented by other more sophisticated techniques such as 3D echocardiography and speckle tracking. However these methods require a high technicity and a good echogenicity. As heart failure leads to lengthening of aortic pre-ejectional time [PET] and shortening of left ventricular ejection time [ET], systolic time intervals [STI] were proposed for the evaluation of systolic myocardial performance. To establish a correlation between left ventricular ejection fraction [LVEF] and STI and determine a cut-off value of PET/ET ratio to diagnose a LVEF inferior to 35%. 109 consecutive patients referred to two echocardiographic laboratories had measurements of STI and LVEF estimated by Simpson biplane method. Patients included were in sinus rhythm with a heart rate<100 beats per minute. Patients with atrial fibrillation, pacemaker or prosthetic valves were excluded. Results: Feasibility of STI measurements was 100%. A significant negative correlation between PET and LVEF was found [r=-0.49, p<0.0001]. LVEF was also significantly correlated to ET [r=0.44, p<0.0001]. PET/ET ratio was significantly correlated to LVEF [r=-0.63, p<0.0001]. Receiver operating curve analyses revealed a cut-off value of PET/ET ratio of 0.33 to diagnose a LVEF<35% with a sensitivity of 85% and a specificity of 78%. STI, easy to obtain and useful in case of poor quality echographic window, are an interesting alternative to evaluate systolic left ventricular function and may be used to detect alteration of LVEF

Cout direct medical de la prise en charge de l'infarctus du myocarde en phase algue

to assess the medical direct cost of acute myocardial infarction. Method: data are recorded through a prospective study in 7 wards of cardiology of the District of Tunis during one year: from November 2001 to October 2002. cost of hospital stay, biologic analyses, drugs, functional investigations and possible non surgical cardiologic intervention [IC] was calculated. 632 AMI cases are recorded, the death rate is 7.8%. The average of hospital stay was 13.3 days. 49.1% of patients benefited from thrombolytic therapy, 55.5% benefited from a coronary angiography and 16.1% of an act of IC. The mean of direct cost [CGM] was 2171 Tunisian Dinars and the median was 1731 DT, of whom room costs 31.7%, 22.5% acts of IC, 7.2% drugs, 26.2% functional investigations and 12.4% biological analyses. The mean cost of IC was 3030 +/- 401 DT. The methodology of our study remains original in our country and can be used to assess the other aspects of AMI as other diseases cost management

Embolie pulmonaire hydatique compliquant un kyste hydatique du coeur. A propos d'un cas

Hydatic pulmonary embolism complication of a cardiac hydatic cyst:a case report Hydatic cardiac cyst is a rare condition and represents only 0.5 to 2% oF all visceral localisations of the hydatid disease. We reported a 28 year old patient with a multiple hydatic pulmonary embolism caused by the rupture of a hydatic cyst of the interventricular septum. The diagnosis was established by transthoracic echocardio-graphy and CT Scan. Surgery was performed without delay and the outcome was good after a five month follow-up This case illustrates the diagnostic value of the non invasive imaging means in hydatic cyst of the heart and underlines the importance of surgery realized before complications occur