Cardiac Hydatidosis

Abstract

A 37-year-old man from Morocco, living in France since 2002, was admitted to the hospital in 2008 with a medical history of dyspnoea, hacking cough, and headaches without fever for several weeks. Physical examination at admission revealed jugular turgor leading to the diagnosis of superior vena cava syndrome. Cardiopulmonary auscultation was normal. There were no complaints of abdominal pain. No lymphadenopathy was palpable. During the past year, he had presented several episodes of pruriginous facial edema that were unsuccessfully treated with corticosteroids. Allergologic explorations were negative. His medical history showed nothing unusual, and he was not taking medication. Laboratory blood tests did not reveal blood-cell count abnormalities, inflammatory syndrome, or abnormalities of liver function. Cardiac ultrasound showed several intracardiac multilocular masses of anechoic content with a well-demarcated capsule, which is very typical of a hydatic cyst. A thoracic computed tomography scan revealed the presence of several lesions: the first was compressing the vena cava, and two others were in the left and right ventricles. Further investigation was performed with cardiac magnetic resonance imaging (MRI) ( Figure 1 ).The characteristic radiological findings associated with a positive serology for echinococcosis led us to diagnose cardiac hydatidosis. Differential diagnoses, principally cystic cardiac tumors, were then eliminated. Parasitic infection was confined to the heart and absent in the liver, lungs, and brain. The patient was treated with albendazole (800 mg daily). The evolution of the lesions was monitored with cardiac echography.

Superior Vena Cava Syndrome Secondary to the Largest Reported Thoracic Hydatid Disease

“…SVC compression secondary to intrathoracic hydatid cysts is extremely rare. Scientific literature has some evidence of cardiac hydatidosis presenting as SVC syndrome [ 7 ]; however, our extensive literature search did not yield a case where the hydatid disease of the pleura, lung, or mediastinum resulted in the typical presentation of SVC obstruction, rendering this presentation unique.…”

“…Our patient presented with progressively worsening cough, chest pain, and dyspnea secondary to the mass effect and tension physiology of the intrathoracic cysts. Other less common symptoms not seen in this case include nausea, vomiting, malaise, and thoracic deformation [ 6 , 7 ].…”

Heart Hydatid Cyst Close to the Left Descending Artery in a Thirteen-Year-Old Boy

“…Transthoracic and transesophageal echocardiography play a central role in diagnosing cardiac hydatid cysts. Nuclear MRI is helpful in determining extracardiac extensions of the cysts ( 5 ). Because recurrence may appear much later, such a monitoring should be pursued for at least three years ( 5 ).…”

“…Nuclear MRI is helpful in determining extracardiac extensions of the cysts ( 5 ). Because recurrence may appear much later, such a monitoring should be pursued for at least three years ( 5 ). Albendazole is active against the germinal membrane of the cyst wall but its concentrations in cyst fluid may be suboptimal.…”