Magnetic resonance imaging characteristics of cardiac hydatid cyst

Cardiac cystic echinococcosis-A systematic review and analysis of the literature

Human cystic echinococcosis (CE) is a parasitic infection caused by the larval stage of the tapeworm Echinococcus granulosus sensu lato, primarily affecting the liver and lungs. Although the heart is affected in only 0.02-2% of all CE cases, a considerable number of cases have been, and continue to be, published. However, due to the rare occurrence of cardiac CE and the resulting lack of clinical trials, knowledge about various aspects of the disease remains limited. To obtain a clearer picture of anatomical, clinical, diagnostic as well as therapeutic aspects of cardiac CE, we systematically reviewed the literature published between 1965 and 2022. The anatomical pattern of the affected cardiac structures follows the extension of the supplying capillary bed. The majority of patients (82.7%) are symptomatic and present with prolonged non-specific symptoms such as dyspnoea, chest pain and palpitations. Acute complications generally derive from cyst rupture, occur in 18.3% of cases and manifest as embolism, pericardial tamponade, or anaphylactic reaction in 83.2%, 17.8% and 10.9% of these cases, respectively. As for CE cysts localized in other organs, the diagnosis of cardiac CE is made by imaging. Serology plays a minor role due to its limited sensitivity. Unlike abdominal CE cysts, cardiac CE cysts are usually resected independent of their stage (active/inactive), because their presence impairs cardiac performance and carries the risk of long-term sequelae. More than 80% of patients are treated with a single surgical intervention. We found a disease-related case fatality rate of 11.1%. Since local recurrence was reported up to 108 months and secondary CE up to 72 months after surgery, patients should be followed up for a minimum of 10 years.

A rare combination of cardiac and pulmonary cyst and review of the literature

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Combination of heart and lung hydatid cyst is rare.

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Echocardiography remains the most accurate diagnostic tool for cardiac hydatid cyst.

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Surgical treatment for cardiopulmonary hydatid cysts is necessary.

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Cardiac and pulmonary hydatid disease can undergo radical resection in one-stage.

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One stage surgery is safe and satisfactory, it decreases the hospital stay and costs.

Hydatid disease remains an important public health problem in endemic areas. We report a rare case of intramyocardial hydatid cyst of the right atrium along with a pulmonary hydatid cyst in a 16-year-old girl who was admitted to our hospital because of chest pain with recurrent episodes of fainting. One-stage surgery by median sternotomy under cardiopulmonary bypass was performed with excision of the hydatid cyst in the right atrium followed by the removal of the pulmonary hydatid cyst in the same session. Her postoperative recovery was uneventful. Based on this case, we emphasize, the rare combination of cardiac and pulmonary hydatid cyst. Another aspect that makes this case interesting is the location of the hydatid cyst at the right atrium, which is very rare. To the best of our knowledge, our case is the first to describe the combination of a hydatid cyst of the right atrium and the lung.

Dynamic right ventricular outflow tract obstruction by cardiac hydatic cysts: A multimodality imaging study

We report the case of massive hydatic heart disease in a 50-year-old male patient referred to hospital for recent-onset dyspnea, atypical chest, and hypotension. Right ventricular outflow tract obstruction was demonstrated to be caused by hypoechogenic formations at Doppler-echocardiography and confirmed to be hydatic cysts at cardiac magnetic resonance. These cysts developed within the right ventricular wall and the septum, and caused hemodynamic instability.

Surgical Management of Cardiac Hydatid Cyst and the Residual Intramural Ectocyst

The cardiac hydatid cyst (HC) is a rare pathology and mostly is endemic in livestock raising countries. Patients do not have a specific presentation so it is mainly a diagnosis based on imaging. Finding HC anywhere in the body warrants looking for another hydatid in other organs. This is a case report of a young male who presented with nonspecific symptoms and during diagnostic workup, it happened that he has combined hepatic and cardiac HCs. The cardiac cyst was located intramurally in the interventricular septum and expanding down mostly to the left side of the diaphragmatic surface of the heart and partly crossing intramurally to the diaphragmatic surface of the right ventricle. Emergency open-heart surgery was performed; the endocyst was removed while intramural ectocyst was drained to prevent potential future residual space.

Myocardial Echinococcosis: Rare Manifestation of a Common Parasitic Disease in Northern Tanzania

Hydatid (Echinococcal) disease often involves the liver and lungs but in sporadic cases, it can involve cardiac structures. A 24-year-old male was referred with symptoms of cough and shortness of breath and a provisional diagnosis of metastatic disease of unknown primary to the lung, which was based on a chest X-ray (CXR). Incidentally, on echocardiogram, he was found to have right ventricular (RV) and myocardial multiseptated cysts, which were compatible with cardiac echinococcosis, as the patient had multiple bilateral lung cysts as well. Imaging with ultrasound, computed tomography (CT) scan, and magnetic resonance imaging (MRI) has ameliorated the diagnosis of hydatid disease location in various body parts. However, for earlier and accurate diagnosis, a high index of suspicion is required in endemic areas, especially in vulnerable populations such as pastoralists.