Progress of Untreated Massive Cardiac Echinococcosis—Echocardiographic Follow‐Up

Abstract

A 56-year-old man was admitted with chest pain and dyspnea. Echocardiographic evaluation revealed a giant cystic cardiac mass with multiple loculations at interventricular septum extended to inferoposterior region protruding inside the cavity. The patient refused surgical therapy. His complaints persisted without significant changes after 5 months. Second echocardiographic evaluation revealed conjugation of previous multiple cyst to gigantic intramyocardial cyst and minimal pericardial effusion. We intend to illustrate herein an unusual echocardiographic appearance and progress of an untreated massive "cardiac echinococcosis." If cardiac hydatid cyst is left untreated it may transform to large cavity with a high risk of rupture.

Case report of a primary multiloculate muscular cystic hydatidosis

“…To our knowledge, very few cases of giant hydatid cysts have been described in the literature worldwide; giant hydatid cysts are defined as cysts measuring 10 cm or more [26]. Most of the reported giant hydatid cysts are localized in the lung, liver, thoracic and abdominal cavity, and spleen [27][28][29]; the muscle is also a rare location for giant cysts, and the only reported cases were localized in the diaphragm and in the heart [30][31][32].…”

Isolated Invasive Endomyocardial Cystic Echinococcosis Presenting with Heart Failure

“…Although cystic echinococcosis grows usually very slowly in the myocardium and may remain asymptomatic for a long period it can also show rapid progression [7]. Early diagnosis of cardiac cystic echinococcosis is rather difficult beacuse of long interval between beginning of the infestation and development of symptoms and besides symptoms are nonspecific [8].…”

Isolated multiple invasive cardiac hydatid cyst

“…Most commonly involved organs are liver (55–70%) and lung (18–35%). Isolated multiple cardiac involvement is very rare 2. Clinical outcome and prognosis depend on the location, number and size of cysts 3.…”