Multimodality imaging of an interventricular septum hydatid cyst

Area of Science:

• Cardiology
• Parasitology
• Medical Imaging

Background:

• Cardiac hydatidosis, caused by Echinococcus infection in humans, is exceptionally rare, particularly when located on the interventricular septum.
• Echocardiography is the primary diagnostic tool, but advanced imaging modalities are crucial for comprehensive assessment.
• Multimodality imaging, including cardiac magnetic resonance (CMR) and computed tomography (CT), aids in diagnosis and surgical planning for cardiac hydatid disease.

Purpose of the Study:

• To present a rare case of cardiac hydatidosis involving the interventricular septum.
• To highlight the role of multimodality imaging in diagnosing and planning surgical intervention for cardiac hydatid.
• To underscore the challenges and prognosis associated with cardiac hydatid disease.

Main Methods:

• A 29-year-old male presented with dyspnea and was diagnosed with cardiac hydatid on the interventricular septum via echocardiography.
• Computed tomography (CT) and cardiac magnetic resonance (CMR) imaging were utilized to confirm the diagnosis.
• Positron emission tomography (PET) was performed to assess for active uptake, and CT pulmonary angiography evaluated for thromboembolic complications.

Main Results:

• Echocardiography identified a cardiac hydatid cyst on the interventricular septum.
• CT and CMR imaging confirmed the diagnosis and provided detailed anatomical information.
• CT pulmonary angiography revealed extensive pulmonary thromboembolization and lung consolidation.
• PET imaging showed no active uptake in the cardiac hydatid cyst.
• Despite surgical enucleation, the patient experienced worsened hypotension and ultimately succumbed.

Conclusions:

• Cardiac hydatidosis, especially involving the interventricular septum, is associated with a poor prognosis.
• Multimodality imaging is essential for accurate diagnosis and effective surgical planning in cardiac hydatid cases.
• Prompt diagnosis and comprehensive management are critical, though outcomes remain challenging.