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

Area of Science:

• Cardiology
• Parasitology
• Medical Imaging

Background:

• Hydatid disease, caused by the tapeworm Echinococcus granulosus, typically affects the liver and lungs.
• Cardiac involvement is rare but can lead to severe complications due to the heart's vital function.

Observation:

• A 50-year-old male presented with dyspnea, chest pain, and hypotension.
• Doppler echocardiography revealed hypoechogenic formations causing right ventricular outflow tract obstruction.
• Cardiac magnetic resonance imaging confirmed the presence of hydatid cysts within the right ventricular wall and septum.

Findings:

• Massive hydatid cysts were identified as the cause of right ventricular outflow tract obstruction.
• The cysts' location within the ventricular wall and septum led to significant hemodynamic compromise.
• The patient experienced severe symptoms including dyspnea and hypotension due to the cardiac mass.

Implications:

• This case underscores the importance of considering parasitic infections in the differential diagnosis of cardiac masses and outflow tract obstruction.
• Prompt and accurate diagnosis using advanced imaging modalities like cardiac MRI is crucial for effective management.
• Early intervention for cardiac hydatid disease is essential to prevent life-threatening hemodynamic instability and improve patient outcomes.