20 https://www.id-press.eu/mjms/index Scientifc Foundation SPIROSKI, Skopje, Republic of Macedonia Open Access Macedonian Journal of Medical Sciences. 2021 Jan 20; 9(C):20-24. https://doi.org/10.3889/oamjms.2021.5533 eISSN: 1857-9655 Category: C - Case Reports Section: Case Report in Surgery Perioperative Evaluation of Heart Echinococcus Cyst in a 14-Year-Old Child Saimir Kuci 1 *, Alfred Ibrahimi 1 , Shaban Memeti 2 , Stavri Llazo 1 , Ervin Bejko 1 , Klodian Krakulli 3 , Edvin Prifti 3 1 Department of Cardiac Anesthesia, Mother Teresa University Hospital Center, Tirana, Albania; 2 University Clinic of Paediatric Surgery, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia; 3 Department of Cardiac Surgery, Mother Teresa University Hospital Center, Tirana, Albania Abstract BACKGROUND: Echinococcosis of the heart has a rate 0.02–2% of all hydatid diseases. Clinical presentation is depending of the location of hydatid cyst in the heart. Patients can be an asymptomatic case or lethal stroke, arrhythmias, valvular dysfunction, pulmonary edema, cardiac tamponade, cardiac failure, shock, and even death. CASE REPORT: We present a case report, a 14-year-old child with 2 weeks of sore throat, whooping cough, subfebrile condition, sweating, fatigue and physical weakness, nausea, abdominal pain, and decreased appetite. He came to emergency room with cardiogenic shock and pulmonary edema. He was diagnosed with intramyocardial hydatid cyst. CONCLUSION: Echinococcus cyst lesion in the LV in lateral wall, not communicating with the LV cavity, has been removed successfully with on-pump technique in a 14-year-oldchild. Median sternotomy was preferred and cardiopulmonary bypass has been considered the safest method. Supplemental medical therapy with albendazole is recommended to reduce the risk of recurrence. Edited by: Igor Spiroski Citation: Kuci S, Ibrahimi A, Memeti S, Llazo S, Bejko E, Krakulli K, Prifti E. Perioperative Evaluation of Heart Echinococcus Cyst in a 14-Year-Old Child. Open Access Maced J Med Sci. 2021 Jan 20; 9(C):20-24. https://doi.org/10.3889/oamjms.2021.5533 Keywords: Echinococcosis; Intramyocardial hydatid cyst; Left ventricle; Albendazole; Cyst cavity *Correspondence: Saimir Kuci, Department of Cardiac Anesthesia, Mother Teresa University Hospital Center, Rr. Dibres 372, Tirana, Albania. E-mail: saimirkuci@gmail.com Received: 23-Oct-2020 Revised: 05-Jan-2021 Accepted: 10-Jan-2021 Copyright: © 2021 Saimir Kuci, Alfred Ibrahimi, Shaban Memeti, Stavri Llazo, Ervin Bejko, Klodian Krakulli, Edvin Prifti Funding: This research did not receive any fnancial support Competing Interests: The authors have declared that no competing interests exist Open Access: This is an open-access article distributed under the terms of the Creative Commons Attribution- NonCommercial 4.0 International License (CC BY-NC 4.0) Introduction Echinococcosis is a parasitic disease of tapeworms of the Echinococcus type. The two main types of the disease are cystic echinococcosis and alveolar echinococcosis. Less common forms include polycystic echinococcosis and unique cystic echinococcosis [1]. Cardiac involvement occurs in 0.02–2% of all hydatid diseases [3], [4] The embryos can reach the myocardium through coronary circulation from the left side of the heart. The most common locations of cardiac hydatid cysts are on the left ventricle (LV), interventricular septum, and right ventricle (RV) [5]. Cardiac symptoms (mostly chest pain, shoulder pain, dyspnea, and persistent cough) usually depend on the localization and the size of the cyst. The cyst may also grow between cardiac fbers without causing any symptoms. If it reaches a reasonable size, fever, palpitation, arrhythmia, and heart failure may develop. The most critical complication of a cardiac cyst is perforation with a high incidence ranging between 25% and 40%. After perforation of the cyst, 75% of patients died due to septic shock or embolic complications. Case Report We present a 14-year-old child resident in Kukes (north of Albania) who comes to the emergency room of “Mother Teresa” University Hospital Centre of Tirana, with temp 39°C, shortness of breath, dyspnea, paroxysmal supraventricular tachycardia, AP-70/50 mmHG, FC-157 b/min, and metabolic acidosis. Anamnesis He complained about 2 weeks of sore throat, whooping cough, subfebrile condition, sweating, fatigue and physical weakness, nausea, abdominal pain, and decreased appetite. He transferred to cardiac intensive care unit (ICU) in a bad condition, with dyspnea low AP, FC-150 h/min, and no diuresis. Immediately, we started therapy with O 2 , vagal maneuvers, dopamine 3,5 mcg/kg/min, and antibiotic. • X-Rays: Detect enlargement of the heart, suspect pneumonia Figure 1.