Udupi: Heartache Woes? Worms Flushed Out From Man’s Heart!

By Divvy Kant Upadhyay, Manipal
Daijiworld Media Network - Udupi

Udupi, Dec 3: In what appears to be an exceptionally rare case, doctors at the Kasturba Hospital, Manipal saved a man’s life by detecting and treating worm infestation in his heart, rather than do open heart surgery for which he was referred to them.

Highly experienced surgeons often say a good surgeon is one who knows when not to operate. The same seems to be true in the case of Dr Shirish S Borkar, Consultant Cardiovascular and Thoracic Surgeon at Kasturba Hospital, Manipal.

Dr Shirish Borkar

54 year old Sunder (Name changed) was referred to the hospital after few doctors who saw him said he needed open heart surgery urgently. All he felt was weak and breathless on doing heavy work. That he was a chronic smoker and alcoholic made it only simpler for doctors to associate his habits with his heart disease. At Manipal, he was seen by Dr Shirish Borkar and another cardiologist Dr Ranjan Shetty. ECHO tests and CT scans done on him indicated a mass in the left lower chamber of his heart. Most of the other routine blood and lab test were indeed normal. The case had the doctors perplexed for sometime.

Dr Borkar says, “This was a rare case of hydatid cyst in the heart’s left ventricle (lower chamber) which was treated medically and the condition resolved successfully on treatment by drugs commonly given to fight worms”. A week later the ECHO test done on Sunder showed the masses in the heart had almost disappeared.He has improved, is less breathless now and is able to do all his work - all this without any open heart surgery.

The worms that rarely find their way to organs such as liver or even more rarely to the lung, in this case had found their way to the heart. Thankfully, they remained within the cyst-formation, because had the cyst ruptured, the parasitic infection would have spread throughout the body and lead to “catastrophic consequences”.

Dr Borkar explains that “Hydatid cysts are cysts of Ecchinococcus Granulosus or commonly known as dog tape worm. Humans are accidental intermediate hosts in the parasite’s life cycle. It is an infectious disease usually found in developing nations. Cysts can be found in practically any part of body but common sites are liver, lung, kidney and brain. Few cysts have also been reported in the heart, but intra-ventricular cysts, like in this case, have extremely rare occurrence”.

Nearly four years ago, Nikolay O. Travin and his colleagues at the Pirogov National Medical Surgical Center, Research Center of Thoracic Surgery, Moscow, Russia had published their analysis on current problems and surgical treatment of Heart echinococcosis. Their report stated that hardly 0.2 to 2 percent of all cases of worm infestation are seen affecting the heart.

Now Manipal University’s team of Dr Borkar, Dr Shetty and medical intern Dr Aman Chauhan are in the process of reporting this unusually rare case to the medical fraternity of the world.