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

Abstract

Introduction:Hydatid cyst is a significant health problem in underdeveloped and developing countries, particularly among sheep breeders. Although cardiac involvement is seen only in 0.2% to 3% of the cases, early diagnosis and treatment are important.Case Presentation:A 13-year-old boy with dyspnea and atypical pericardial type chest pain for three months was referred to us. Chest X-ray revealed linear calcification in the left side of the heart. Computed tomography demonstrated a cyst with peripheral calcification and without internal septation in the lateral left ventricle (LV) myocardium. Serologic IgG test was positive for Echinococcosis. No other cyst was seen in the other organs such as the lungs and liver. By midline sternotomy on pump, an incision was made 2-cm lateral to the left ascending artery through the LV myocardium and without entering any cardiac chamber. After injecting hypertonic (5%) saline, the cyst was punctured and its fluid contents were aspirated, the cyst was enucleated, and the cavity marsupialization was done for protection of the myocardium. LV ejection fraction before operation was 40% but after operation and repairing LV myocardium, ejection fraction increased to 50% in. Histopathologic examination confirmed a hydatid cyst.Conclusions:In myocardial hydatid cysts, we recommend a direct approach without entering the cardiac chambers to avoid dissemination of the infection. We recommend excision of the germinative membrane without capitonnage to avoid impairment of myocardial contraction.

Cardiac Hydatid Cyst: First Ever Documented Case in Bangladesh

“…Hydatid cysts are commonly found in the liver (50%-70% of cases), lungs(5%-30%), muscles (5%), bones (3%), kidneys (2%), spleen (1%) and brain (1%) 1,2 . Isolated cardiac involvement is rare and occurs in only 0.02-2% of cases 5 .It is reported from nearly all geographic areas of Bangladesh but cardiac hydatidcysts are not yet reported.…”

“…Computed tomography and MRI provide further information, such as the extent and anatomic relationships of the cysts 1,5 .The presence of calcification in cystic lesion in echocardiography and MRI can be helpful to distinguish it from other cardiac cystic lesions 6,15 . Other helpful findings in MRI are presence of daughter cysts, and membrane detachment 1 .…”

“…The frequency of cardiac involvement is less than 2% 4,5 . Intracardiactumours, congenital cysts and aneurysms are in differential diagnosis of this lesion 6,7 .…”

Isolated cardiac hydatid cyst mimicking myocardial ischaemia in a female patient

“…5 Chest radiographs usually show a normal cardiothoracic ratio, but the presence of calcification may be a sign for hydatid disease. 6 Electrocardiographic findings vary according to the sites of the cysts, and non-specific changes such as T-wave abnormalities may be observed. Echocardiography is highly sensitive for the diagnosis of cardiac hydatid cysts.…”

“…In highly endemic areas, cardiac disease should be kept in mind even in the absence of past medical history of hydatid disease 5 . Chest radiographs usually show a normal cardiothoracic ratio, but the presence of calcification may be a sign for hydatid disease 6 . Electrocardiographic findings vary according to the sites of the cysts, and non-specific changes such as T-wave abnormalities may be observed.…”