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. 2015 Oct;27(4):286-91.
doi: 10.1016/j.jsha.2015.04.003. Epub 2015 May 1.

A huge cardiac hydatid cyst: An unusual cause of chest pain revealing multivisceral hydatidosis in a young woman

Salma Charfeddine  1 , Souad Mallek  1 , Majdi Gueldiche  2 , Faten Triki  1 , Hela Ben Jmâa  2 , Imed Frikha  2 , Samir Kammoun  1
Affiliations

A huge cardiac hydatid cyst: An unusual cause of chest pain revealing multivisceral hydatidosis in a young woman

Salma Charfeddine et al. J Saudi Heart Assoc. 2015 Oct.

Abstract

Hydatid disease remains endemic in some parts of the world. Cardiac hydatidosis with multivisceral involvement is uncommon but potentially fatal. We report the case of a 36-year-old Tunisian woman admitted with chest pain and T-wave inversion in the inferior leads on her electrocardiogram. Transthoracic echocardiography revealed a large hydatid cyst in the epicardium throughout the left ventricle. Thoraco-abdominal computerized tomography (CT) scan showed several hydatid cysts in the left lung, the liver, and in both breasts. After one week of albendazole treatment, surgical excision of the cardiac cyst on cardiopulmonary bypass was carried out as well as excision of the pulmonary and breast cysts. The postoperative course was uneventful and albendazole treatment was continued for six months. Though hydatid cardiac involvement is very rare, it should be considered in the differential diagnosis of atypical chest pain in young patients, especially those living in regions where hydatid disease is endemic.

Keywords: Cardiac hydatid cyst; Chest pain; Hydatid disease.

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Figures

Figure 1a
Figure 1a
Trans-thoracic echocardiography showing a large cardiac cyst, covering half of the posterior left ventricular wall.
Figure 1b
Figure 1b
Transthoracic echocardiography showing a giant rounded cystic mass measuring 50 × 48 mm on the posterior left ventricular wall.
Figure 2a
Figure 2a
Thoracoabdominal CT scan showing a large epicardial cystic mass (50 × 40 mm) close to the posterior left ventricular wall with partially calcified edges.
Figure 2b
Figure 2b
Thoracoabdominal CT scan showing a heterogeneous cyst in the left lung.
Figure 2c
Figure 2c
Thoracoabdominal CT scan showing well-defined cysts in the right liver and the left ventricle.
Figure 3
Figure 3
Mammography showing bilateral well-defined heterogeneous cysts with partially calcified edges in both breasts.
Figure 4
Figure 4
Surgical treatment of the cardiac hydatid cyst: a–e. (a) Peroperative view showing a huge epicardial hydatid cyst covering the posterior left ventricular wall. (b) Total ablation of the germinative membrane of the hydatid cyst. (c) Uncompleted excision of the hydatid cyst showing the residual cavity. (d) Capitonnage of the cavity wall made by U-shaped interrupted sutures. (e) The germinative membrane and the content of the cardiac hydatid cyst.
Figure 4
Figure 4
Surgical treatment of the cardiac hydatid cyst: a–e. (a) Peroperative view showing a huge epicardial hydatid cyst covering the posterior left ventricular wall. (b) Total ablation of the germinative membrane of the hydatid cyst. (c) Uncompleted excision of the hydatid cyst showing the residual cavity. (d) Capitonnage of the cavity wall made by U-shaped interrupted sutures. (e) The germinative membrane and the content of the cardiac hydatid cyst.
Figure 5
Figure 5
Control trans-thoracic echocardiography showing the residual cavity (a and b).
See this image and copyright information in PMC

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