Pericardial Hydatid.
Cardiac hydatid cysts represent only 0.5%–2% of cases
of systemic echinococcal infection. The most common
location is the left ventricle, followed by the interventricular
septum and right ventricle. Cysts in the pericardium, right
atrium or left atrium are very rare. The clinical picture
depends on the location and size of the cyst. Patients with
cardiac hydatid cysts are usually asymptomatic, although
mild, recurrent, nonspecific chest pain is the most common
complaint. This may be due to episodes of partial rupture
into the pericardium, with resulting pericarditis or because
of external compression of the coronary artery. If cardiac
hydatid cysts are left untreated, they usually rupture into
the heart chamber or pericardium and may cause
pulmonary or systemic embolization, tamponade or
anaphylactic shock.Even constrictive pericarditis
secondary to a pericardial hydatid cyst has been reported.
Two-dimensional echocardiography is the best
diagnostic procedure to demonstrate a cardiac hydatid cyst.
On echocardiography, a unilocular cyst with well-defined
margins and internal trabeculations corresponding to
daughter cysts is diagnostic of a hydatid cyst. More
recently, MRI has been used to provide a diagnosis of
hydatid cyst based on the characteristic low-intensity rim
on both the T1-weighted and T2-weighted images in a cystic
mass. This rim represents the fibrous tissue-rich pericyst
in a hydatid cyst.
LAB
LAB
The serologic diagnosis is not reliable, although it has
high specificity, but sensitivity is low in patients with intact
cysts as the concentration of the antibody in serum is very
low until the cyst leaks.
TREATMENT
TREATMENT
Surgical excision remains the treatment of choice for
cardiac hydatid cysts. Oral albendazole therapy has also
been used to reduce the size of the cyst and to prevent
recurrence.