Cardiac Involvement in Patients with Trichinosis Hospitalized in Western Romania Raul Neghina, Adriana Maria Neghina, Iosif Marincu, and Ioan Iacobiciu Abstract Objectives: Cardiovascular disturbances are reported as major trichinosis complications, and myocarditis is the most frequent of them. Previous Romanian surveillances on prevalence of cardiac involvement indicated a rate of 30%–50%. The present study aimed to overview the clinical and the main epidemiological characteristics of persons from western Romania found to have trichinosis and cardiac involvement. Patients and Methods: Hospitalization documents of individuals with trichinosis and cardiac complications admitted at the Hospital of Infectious Diseases in Timisoara, Romania, were retroactively investigated. Patients were residents of three Romanian counties and were hospitalized between 1990 and 2001. Results: Twenty-eight patients, found to have trichinosis, presented cardiac involvement. Of the study group, six patients (21.4%) died during hospitalization and their necropsy revealed the diagnosis of myocarditis. For the remaining patients, myocarditis was only suspected and cardiac abnormalities were mainly evidenced by electrocardiography. The mean age of the patients was 38 years (range, 3–80 years) and there were 18 male patients (64.3%). Repolarization disturbances predominated and myalgia was the most common symptom. The mean eosinophil value of the study group was 16.9% (range, 2–70%). Conclusions: Cardiac involvement represented and still continues to be a major complication in Romanian patients. According to its potentially lethal outcome, myocarditis must be considered in such patients even when specific symptoms are missing. Prophylactic measures are also very important and should be based especially on health education programs for the masses. Introduction C ardiovascular disturbances are reported as major trichinosis complications (Dupouy-Camet et al., 2002). Myocarditis is the most frequent of them (Bruschi and Mur- rell, 2006) and occurs in 5%–20% of cases (Dupouy-Camet et al., 2002; Dupouy-Camet and Bruschi, 2007). Findings are not specific and may include chest pain, palpitations, short- ness of breath, tachycardia, and electrocardiogram (ECG) anomalies (Schantz and Dietz, 2001; Dupouy-Camet et al., 2002; Dupouy-Camet and Bruschi, 2007; Franco-Paredes et al., 2007). The majority of myocardial changes develop during the invasive phase of the illness (Tint et al., 2009). Trichinosis is considered the most significant and wide- spread parasitic disease in Romania. The average yearly in- cidence was 6.2 cases per 100,000 inhabitants during the period 1990–2007 (Neghina et al., 2010). Previous Romanian surveillances on prevalence of cardiac involvement indi- cated a rate of 30%–50% in 1960 and 1994 (Olteanu et al., 1999; Enache, 2005). The aim of the present study was to overview the clinical and the main epidemiological characteristics of persons with trichinosis and cardiac involvement hospitalized in western Romania between 1990 and 2001. Patients and Methods Hospitalization documents of 28 patients with trichinosis and cardiac complications admitted at the Hospital of In- fectious Diseases in Timisoara, Romania, were retroactively investigated. Patients were residents of three Romanian counties and were hospitalized between 1990 and 2001. The following information was extracted: registration number of the medical record, age, sex, address, date and length of hospital stay, profession, clinical symptomatology, routine laboratory tests, cardiac investigations, and specific therapy. Trichinosis was mainly confirmed by positive muscle biopsy and/or positive serology. Statistical evaluation was performed using the software package SPSS version 17.0 for Windows (SPSS, Inc., Chicago, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. FOODBORNE PATHOGENS AND DISEASE Volume 7, Number 10, 2010 ª Mary Ann Liebert, Inc. DOI: 10.1089/fpd.2010.0573 1235