Apical cardiac hydatid cyst compressing the left ventricle: An uncommon manifestation of echinococcosis

TL;DR

A rare case of a heart hydatid cyst in a woman was successfully treated with surgery and medication.

Contribution

A case report of apical cardiac hydatid cyst managed surgically with cardiopulmonary bypass and albendazole.

Findings

Cardiac hydatid cysts are rare and often asymptomatic until large or complicated.

Surgical excision under cardiopulmonary bypass and albendazole therapy led to full recovery.

Echocardiography and CT are key for diagnosis in endemic regions.

Abstract

Cardiac hydatidosis is a rare but serious manifestation of Echinococcus granulosus infection, accounting for less than 2 % of all hydatid disease cases. Ventricular involvement is exceptional, and cyst degeneration can mimic infection. Prompt recognition and surgical intervention are essential to prevent complications such as rupture, tamponade, or coronary compression.

A 36-year-old woman with prior hepatic hydatid cystectomy presented with progressive dyspnea. Echocardiography and CT revealed a large cystic lesion compressing the left ventricular apex. The cyst was completely excised under cardiopulmonary bypass without aortic cross-clamping. Histopathology confirmed E. granulosus, and the postoperative course was uneventful.

Cardiac hydatid cysts can remain silent until they reach a significant size or undergo secondary changes. Diagnosis relies on echocardiography and CT imaging. Radical surgical excision under cardiopulmonary bypass, combined with albendazole therapy, ensures complete recovery and prevents recurrence.

Hydatid disease should be considered in the differential diagnosis of any cystic cardiac lesion in endemic areas. Early surgical management remains crucial to avoid potentially fatal complications.

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