Ruptured hydatid cyst of the interventricular septum with acute embolic pulmonary artery complications

Incidental Asymptomatic Giant Hydatid Cyst of the Interventricular Septum Bulging Into the Right Ventricle

Hydatid disease is caused by the larvae of Echinococcus granulosus. Domestic animals like cats and dogs are the primary carriers of echinococcal organisms. This parasitosis is still endemic in some particular regions of the world. The cardiac hydatid cyst is an exceptional infection. We report a case of an asymptomatic giant cardiac hydatid cyst in the interventricular septum (IVS) protruding in the right ventricular diagnosed incidentally by scan tomography during acute pancreatitis emergency. Transthoracic echocardiography revealed a cystic mass in the IVS bulging into the right ventricle. The diagnosis was confirmed by a cardiac CT scan.

Four pathways for hydatid pulmonary embolism

INTRODUCTION

Hydatid pulmonary embolism (HPE) is rare but remains an etiology that needs to be considered and kept in mind, especially in endemic areas, as regards nonthrombotic embolism.

METHODS

Between 2000 and 2014, 10 patients were treated in our department for the presence of hydatid material in the pulmonary arterial circulation. Through these 10 cases, we try to assess the radioclinical characteristics and results of the surgical treatment.

RESULTS

The study included six men and four women, average age 28 years. Discovery of HPE was made following the exploration of cardiorespiratory symptoms in nine cases and was incidental in a single patient. Computed tomography angiography (CTA) of the chest directly visualized the hydatid material in the pulmonary arteries in nine cases. Surgery consisted of an embolectomy under cardiopulmonary bypass in nine cases. This embolectomy was preceded by the treatment of an embolic hydatid cyst (HC) in seven cases (HCs of the right heart chambers in six cases and a liver HC ruptured in the inferior vena cava in one case), whereas for only one patient, who presented a HC pedunculated in the right ventricle and protruding into the pulmonary artery, the cure of the cardiac location was sufficient. Only one patient died on the third postoperative day.

CONCLUSION

Endoluminal hydatid involvement of pulmonary arteries is extremely rare. CTA chest has an important contribution to the positive diagnosis. Treatment is surgical when the patient's condition allows it.

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.

Giant cardiac hydatid cyst in the interventricular septum protruding to right ventricular epicardium

Cardiac hydatid cyst is a rare condition, and the location of a hydatid cyst in the interventricular septum is exceptional. A 54-year-old female was admitted to our hospital with complaints of chest pain, shortness of breath and malaise. Transthoracic echocardiography defined a cystic mass lesion of 50 × 59 mm originating from apex of the heart protruding into and compressing the interventricular septum. The cyst was excised surgically and the patient was discharged on the 8th postoperative day without symptoms. In our case, localization of the cystic mass was within interventricular septum which is an uncommon site. It limited both ventricular volumes significantly. In addition, this cyst was extensively protruding to the right ventricular epicardium.

A cardiac hydatid cyst underlying pulmonary embolism: a case report

Hydatid cysts located in the interatrial septum are especially rare but when they occur, they might cause intracavity rupture. We report on a patient with acute pulmonary embolism caused by an isolated, ruptured hydatid cyst on the right side of the interatrial septum. A 16-year-old-boy with an uneventful history was hospitalized for exercise-induced dyspnea and blood expectorations. Multiple and bilateral opacities were visualized on standard chest x-ray. Signs of right-sided hypertrophy were seen on ECG. Imaging findings led to the diagnosis of pulmonary embolism complicating cardiac hydatid cysts. An operation was performed through median sternotomy to remove the cardiac cyst. The pleural cavity was entered through the fifth intercostal space to withdraw lung hydatid cysts. Operative recovery was uneventful and the patient resumed his normal activities 19 months later. Prompt diagnosis and an appropriate surgical treatment prevented a potentially fatal outcome.