Cardiac hydatid cysts in a young man: A case report and a literature review

Abstract

Cystic hydatid disease commonly affects the liver and lungs. Cardiac hydatid cysts are a rare occurrence and can cause fatal complications, including anaphylactic shock, systemic or pulmonary embolism, dissemination, arrhythmias, valvular dysfunction or sudden death. The case of a 19-year-old male from a rural area who was admitted to the emergency room with anaphylactic shock is presented in the current study. The patient was subsequently referred to the Department of Pneumology due to a mild fever, a dry cough and thoracic pain. Pneumonia was suspected and antibiotics were administered. As the patient didn't respond to the antibiotics, a pulmonary CT-scan was performed, which demonstrated a bilateral pulmonary embolism of the segmental arteries and the patient was referred to the Department of Cardiology. Transthoracic echocardiography (TTE) demonstrated the presence of a right ventricular mass of ~25x18 mm, attached to its free wall, adjacent to the tricuspid valve causing no tricuspid inflow obstruction. Blood tests were positive for echinococcal infection. Considering that previous reviews had included cases published up until 2018, the present study also included a short literature review of the studies published between 2018 and 2021. The review showed that cardiac hydatid cysts are diagnosed more often in underdeveloped countries, especially in men. Transthoracic echocardiography is the most useful non-invasive imaging technique for diagnosis. Surgery is the treatment of choice, but consideration must be given to the risk-benefit ratio and the shared decision-making approach. The complete surgical removal of the cyst(s) is the major prognosis factor of the cardiac manifestation. This study emphasizes the importance of considering cardiac echinococcosis as a potential diagnosis in patients from endemic or farming areas.

Case Report: Right atrial organized thrombus three years after tricuspid annuloplasty

“…8 Calcified masses such as the calcified amorphous tumour have been reported in patients with end stage renal failure, 9 and cardiac hydatid cysts on the tricuspid valve has also been described. 10 In case of previous cardiac surgery, the presence of prosthetic material can orient the aetiological diagnosis toward the presence of a thrombus. 2,3 Nevertheless, all other causes cannot be excluded, especially when the mass presents years after the operation.…”

Stroke-Associating Acute Limb Ischemia Due to the Rupture of a Hydatid Cyst

“…The treatment of hydatid cysts is an emergency for cardiac/cerebral/pulmonary lesions due to the high risk of mortality and dissemination [ 21 , 24 , 43 , 48 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ]. Surgery or PAIR (puncture, aspiration, injection of protoscolicidal agent and reaspiration) are required for cystic lesions.…”

“…Surgery or PAIR (puncture, aspiration, injection of protoscolicidal agent and reaspiration) are required for cystic lesions. Embolectomy is recommended in all situations of acute arterial obstruction [ 42 , 43 , 44 , 45 , 46 , 58 , 59 , 60 , 61 , 62 , 63 ]. For better treatment outcomes, surgery should be completed with medical therapy comprising benzimidazole drugs (albendazole +/− praziquantel is considered the standard, aiming for scolicidal and anti-cystic activity) [ 43 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ].…”

“…For better treatment outcomes, surgery should be completed with medical therapy comprising benzimidazole drugs (albendazole +/− praziquantel is considered the standard, aiming for scolicidal and anti-cystic activity) [ 43 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. The follow-up to detect the appearance of new lesions is mandatory [ 42 , 57 , 58 , 59 , 60 ].…”

Exertional Dyspnea in a Female Patient Aged 55 Years Without Significant Medical History

“…Hydatid cyst in humans is formed by the larvae of genus Echinococcus , a parasitic flatworm, most commonly involving the liver, and very rarely, the heart (<2%) . Cardiac hydatids are mostly asymptomatic . Cysts of the interventricular septum may present with outflow-tract obstruction and conduction abnormalities .…”