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Primary cardiac hydatid disease. A case report
Insights
A rare cardiac echinococcal cyst caused infundibular stenosis and left anterior hemiblock in a young man. This case highlights the diagnostic utility of echocardiography for cardiac hydatid disease.
Area of Science:
- Cardiology
- Parasitology
- Medical Imaging
Background:
- Echinococcal cysts typically affect the liver and lungs, with cardiac involvement being rare.
- Cardiac echinococcosis can present with diverse clinical manifestations, often mimicking other cardiac pathologies.
- Early and accurate diagnosis is crucial for effective management and improved patient outcomes.
Observation:
- A young man presented with exertional dyspnea and signs of infundibular stenosis.
- Cardiac imaging revealed a large cystic mass in the interventricular septum, causing right ventricular outflow tract obstruction.
- Associated findings included left anterior hemiblock and cardiomegaly.
Findings:
- The cystic mass was strongly suspected to be a primary cardiac echinococcal (hydatid) cyst.
- The cyst was implicated as the cause of both infundibular stenosis and left anterior hemiblock.
- Two-dimensional echocardiography proved effective in delineating the cyst and its impact on cardiac function.
Implications:
- This case underscores the importance of considering parasitic infections in the differential diagnosis of cardiac masses and conduction abnormalities.
- Echocardiography is a valuable non-invasive tool for diagnosing cardiac hydatid disease.
- While surgical intervention is standard, this patient declined surgery, preventing definitive pathological confirmation.
Abstract:
A young Coloured man whose only symptom was that of minimal dyspnoea on exertion, on examination had signs of infundibular stenosis which were confirmed by cardiac catheterization. Additional features were left anterior hemiblock and cardiomegaly as delineated radiologically. Cross-sectional echocardiography revealed a very large cystic mass located within the interventricular septum which encroached upon the right ventricular outflow tract. This cystic mass was further delineated by cardiac cine angiography. It is postulated that this mass was a primary cardiac echinococcal cyst and was directly responsible for the complications of left anterior hemiblock and the infundibular obstruction. The patient declined surgery and a definitive pathological diagnosis could therefore not be made. If this is a hydatid cyst then it is the second case reported in the literature diagnosed by two-dimensional echocardiography and in which left anterior hemiblock has been recorded. The clinical features, complications and surgical correction are briefly outlined.