Endocardial hydatid cyst: a rare presentation of echinococcal infection

A previously well 45-year-old male presented with 20 days of being generally unwell with a fever and dyspnoea on exertion. Transthoracic echocardiography was done and revealed a round cystic structure (3 x 3 cm) attached to the tricuspid valve. Multiple small calcified particles (daughter cysts) were also seen in the cyst which was most consistent with the diagnosis of Hydatid cyst. The serology for Echinococcus granulosus antibody was positive and confirmed the diagnosis. The patient was sent for cardiac surgery and hydatid cyst which was endocardial in location, and adherent to the tricuspid valve leaflets was the intraoperative finding. The patient improved and was discharged on long-term chemotherapy. The most common cite of cardiac involvement is the myocardium followed by the pericardium, whereas endocardial involvement is extremely rare. In the present study, we demonstrated a very rare case of endocardial hydatid cyst with attachment to the tricuspid valve.