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[Cardiac echinococcosis]
Branislava Ivanović-Krstić1, Dimitra Kalimanovska-Ostrić, Bosiljka Vujisić-Tesić
1Institute of Cardiovascular Diseases, Clinical Centre of Serbia, Belgrade.
Insights
Cardiac hydatid disease is rare, involving multiple heart structures. This case highlights a challenging hydatid cyst presentation with poor outcomes despite treatment.
Area of Science:
- Cardiology
- Parasitology
- Infectious Diseases
Background:
- Hydatid disease, caused by Echinococcus granulosus, typically affects the liver and lungs.
- Cardiac involvement is rare, often presenting with nonspecific symptoms, making diagnosis challenging.
Observation:
- A 33-year-old woman presented with cough, fever, and chest pain.
- Echocardiography revealed a large cyst in the right ventricle and smaller cysts in the right atrium and tricuspid valve.
- CT confirmed widespread hydatid cysts in the lungs and mediastinum.
Findings:
- Serologic tests for hydatidosis were positive.
- Surgical intervention was deemed too high-risk due to potential cardiac perforation.
- Medical management with albendazole proved ineffective.
Implications:
- This case underscores the diagnostic and therapeutic challenges of rare cardiac hydatidosis.
- Systemic involvement can lead to fatal outcomes, emphasizing the need for early detection and effective treatment strategies.
- Further research into optimal management of disseminated hydatid disease is warranted.
Abstract:
Cardiac hydatid disease is rare. We report on an uncommon hydatid cyst localized in the right ventricular wall, right atrial wall tricuspid valve, left atrium and pericard. A 33-year-old woman was treated for cough, fever and chest pain. Cardiac echocardiographic examination revealed a round tumour (5.8 x 4 cm) in the right ventricular free wall and two smaller cysts behind that tumour. There were cysts in right atrial wall and tricuspidal valve as well. Serologic tests for hydatidosis were positive. Computed tomography finding was consistent with diagnosis of hydatid cyst in lungs and right hylar part. Surgical treatment was rejected due to great risk of cardiac perforation. Medical treatment with albendazole was unsuccessful and the patient died due to systemic hydatid involvement of the lungs, liver and central nervous system.