Intracavitary cardiac hydatid cysts with a high risk of thromboemboli. Invasive nature of cardiac echinococcosis

Intracoronary Hydatid Cyst Resulted in Coronary Artery Disease in a Young Patient

Among all cystic echinococcosis cases, only 0.5%-2% exhibit a cardiac involvement. Only 10% of these become symptomatic. Considering the long time interval between the start of infestation and symptoms to occur, it is hard to diagnose cystic echinococcosis. When detected, even if it is asymptomatic, intramyocardial hydatid cyst requires surgical intervention due to risks of spontaneous rupture and anaphylaxis. In literature, no case of hydatid cyst located in the coronary arterial wall has been reported. Twenty-two-year-old male patient with previous history of pulmonary cystic echinococcosis was referred to us with typical symptoms of coronary artery disease. Coronary cineangiography revealed proximal left diagonal artery (LAD) occlusion. Pre-operative transthoracic echocardiography of the patient planned to undergo coronary artery bypass grafting unveiled an intracoronary calcified cystic mass. In operation, the calcified cystic mass with well-defined borders and size of 2x2 cm located within wall of proximal segment of the LAD artery was excised and double bypass with left internal thoracic artery (LITA) and great saphenous vein grafts to the LAD and first diagonal arteries, respectively, was done. Pathological analysis of the mass revealed it to be an inactive calcified hydatid cyst. Echinococcal IgG-ELISA test was positive. 12-week oral albendazole treatment (2x400 mg/day) was launched postoperatively and the patient was discharged on 7^th postoperative day.

An unusual cause of chest pain: An isolated huge cardiac hydatid cyst

Hydatid disease is a human parasitic infection caused by the larval stage of Echinococcus granulosus. The most common locations for hydatid cysts are the liver and lungs. Cardiac involvement is rare, and isolated cardiac hydatid cysts are even more unusual. We report the case a 48-year-old female patient with an isolated huge cardiac hydatid cyst involving both the left ventricular free wall and the pericardium, and presenting with atypical chest pain. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 46:262-264, 2018.

Non-thrombotic Pulmonary Embolism Due to Liver Hydatic Cyst: A Case Report

Background:

A non-thrombotic pulmonary embolism is defined as embolization to the pulmonary circulation. It may be caused by microorganisms, foreign bodies, different cell types or gas in the pulmonary circulation. Pulmonary hydatid cyst-induced embolization is a rare complication of heart or liver hydatid cysts.

Case Report:

We describe the fatal case of a 15-year-old boy without any known prior illness who was admitted to the hospital after feeling unwell and dropping to the ground while playing ball. During the autopsy, a lesional mass, with dimensions of 13x6 cm, was observed in the left lobe of the liver. The histomorphological examination of pulmonary sections showed scolices observed in pulmonary vessel lumina, thus a non-thrombosis hydatid embolism was diagnosed. Based on the findings, the cause of death was recorded as a non-thrombotic hydatid embolism.

Conclusion:

The present case is interesting because a non-thrombotic pulmonary embolism rarely results in sudden death, and a definitive diagnosis was possible only by a histopathological examination.

Huge right ventricular outflow echinococcosis presenting as acute coronary syndrome

Hydatid disease is a human parasitic infection caused by larvae of Echinococcus granulosus in various sheep- and cattle-raising areas. It can be found commonly in the liver and lungs, but rarely involves the heart. In this report, we present an unusual case in which cardiac echinococcosis mimicked acute coronary syndrome by compressing the right ventricular outflow tract. The patient was referred to our emergency room for typical angina. His electrocardiogram revealed ischemic changes, but coronary angiography was normal. The diagnosis of cardiac echinococcosis was made by transthoracic echocardiography and contrast-enhanced CT and confirmed by pathologic examination. The patient accepted cardiac surgery for resection of the cyst. The postoperative period and follow-up were uneventful. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:518-521, 2016.

Invasive pericardial hydatid cyst: Excision of multiple huge cysts

Cardiac hydatid cyst is rare even in endemic countries, and poses a therapeutic challenge due to varying presentation and unpredictable pre-, peri-, and postoperative complications. We herein present a case of multiple, multifocal, huge pericardial hydatid cyst, with invasion into the left ventricle and main pulmonary artery in a young male patient, presented with atypical chest pain.