Cardiac involvement in parasitic infections

Parasitic infections are an underrecognized but important cause of cardiovascular disease, primarily in endemic regions and increasingly in non-endemic settings as a consequence of global migration and travel. Cardiac involvement may result from direct parasitic invasion or, more commonly, from immune-mediated and inflammatory mechanisms, with predominant effects on the myocardium and pericardium. Clinical manifestations include acute myocarditis, dilated or restrictive cardiomyopathy, pericardial effusion, tamponade, constrictive pericarditis, and occasionally cystic lesions identified on cardiac imaging. Parasitic aetiologies should be considered in patients with unexplained myocardial or pericardial disease, particularly in those with relevant epidemiological exposure, immunosuppression, fever, or eosinophilia. This narrative review offers an updated overview of cardiac involvement in parasitic infections, integrating current evidence on epidemiology, clinical manifestations, diagnosis, and management of parasitic cardiac disease, providing practical, clinically oriented guidance supported by figures, algorithms, and summary tables designed to enhance clinical applicability.