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[Hydatic disease of the heart presenting with pericardial effusion. A case report]
M Nour-Eddine1, R Habbal, J Haddani
1Service de chirurgie cardiovasculaire, CH Ibn-Rochd, Casablanca, Maroc.
Insights
A rare case of ruptured mediastinal hydatid cysts causing pericardial effusion in a 48-year-old man was successfully treated. This highlights the severe complications of cardiac hydatid disease.
Area of Science:
- Cardiology
- Parasitology
- Thoracic Surgery
Background:
- Hydatid disease, caused by Echinococcus granulosus, typically affects the liver and lungs.
- Mediastinal hydatid cysts are uncommon, and their rupture poses significant clinical challenges.
- Pericardial involvement in hydatid disease is exceptionally rare, often presenting with diagnostic difficulties.
Observation:
- A 48-year-old male presented with symptoms suggestive of cardiac tamponade due to pericardial effusion.
- Diagnostic imaging, including 2D echocardiography, CT scan, and MRI, confirmed multiple ruptured mediastinal hydatid cysts.
- The patient exhibited signs of significant pericardial effusion secondary to the ruptured cysts.
Findings:
- Ruptured mediastinal hydatid cysts were identified as the primary cause of the patient's pericardial effusion.
- Echinococcosis of the mediastinum leading to pericardial compromise was confirmed.
- Successful surgical intervention was performed on a semi-emergency basis.
Implications:
- This case emphasizes the importance of considering hydatid disease in the differential diagnosis of mediastinal masses and pericardial effusions, especially in endemic areas.
- Early and accurate diagnosis through advanced imaging is crucial for timely management of cardiac hydatid disease.
- Prompt surgical intervention can lead to favorable outcomes even in complex cases of ruptured hydatid cysts involving the pericardium.
Abstract:
The authors report a rare case of multiple mediastinal hydatid cysts which ruptured in a 48 year old man who presented with a pericardial effusion. The diagnosis was confirmed by 2D echocardiography, completed by CT scan and magnetic resonance imaging. The patient was operated as a semi-emergency and the outcome was good. This case underlines the rare pericardial involvement and the severity of the complications of cardiac hydatid disease.