Primary cardiac hydatid cyst presenting with massive pericardial effusion: a case report

Area of Science:

• Cardiology
• Infectious Diseases
• Parasitology

Background:

• Cardiac hydatidosis, a rare manifestation of Echinococcus infection, accounts for 0.5-2% of hydatid disease.
• While typically affecting the left ventricle myocardium, it can involve other cardiac structures, including the pericardium.
• Clinical presentations range from asymptomatic to severe conditions like cardiogenic shock and sudden death.

Purpose of the Study:

• To report an exceptional case of primary pericardial hydatid cyst.
• To emphasize the diagnostic challenges and potential life-threatening complications of this rare cardiac hydatidosis localization.
• To guide the clinical management of cardiac hydatid cysts, particularly in the presence of pericardial effusion.

Main Methods:

• A case of a 70-year-old woman with dyspnea and right heart failure due to a ruptured primary pericardial hydatid cyst is presented.
• Diagnosis was confirmed using echocardiography, computed tomography (CT) scan, and hydatid serology.
• The patient underwent surgical intervention and a 3-month course of albendazole.

Main Results:

• The patient presented with dyspnea (NYHA class IV) and signs of right heart failure, with a ruptured pericardial hydatid cyst and pre-tamponade.
• Diagnostic imaging and serology confirmed the diagnosis.
• Post-operative treatment with albendazole resulted in a favorable clinical course.

Conclusions:

• Cardiac hydatid cysts should be considered in cases of pericardial effusion, especially with a history of hydatid disease, animal contact, or in endemic regions.
• Accurate differential diagnosis using cardiac imaging is essential to avoid complications.
• Management requires a combined approach of surgery and antiparasitic medication (albendazole or mebendazole).