Rarely a patient with trichinosis may develop cardiac involvement. Migrating larvae do not encyst with the myocardium but they do elicit an eosinophilic inflammatory response.
Cardiac involvement with trichinosis may consist of:
(1) pericarditis
(2) myocarditis
Manifestations:
(1) chest pain that may mimic cardiac ischemia
(2) pericardial effusion
(3) cardiac arrhythmias
(4) changes in the ECG changes
(5) elevated serum troponin concentration
Diagnosis of trichinosis depends on:
(1) concurrent clinical features
(2) eosinophilia
(3) positive serum antibody (appears around third week after exposure)
(4) muscle biopsy
Differential diagnosis:
(1) tuberculous pericarditis
(2) other form of myocarditis
(3) acute myocardial infarction
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