Cardiac Echinococcosis Causing Acute Dissection of the Left Ventricular Free Wall

Abstract

Cardiac echinococcosis is a rare condition, and its manifestations are protean depending upon its site of infestation. We report a case of hydatid heart disease presenting like an acute cardiac ischemic episode associated with a rise in serum cardiac enzymes secondary to left ventricular free wall dissection caused by ruptured intramyocardial echinococcal cyst. The resultant complex cardiac anatomy was characterized fully by echocardiographic examination.

Three‐Dimensional Imaging of a Comma‐Shaped Right Ventricular Hydatid Cyst

“…MRI may have also added value. 5,9 The most common symptoms are chest pain, dyspnea, and syncope. 2,4 Weinberg complement fixation, IgE to echinococcosis, and ELISA tests for echinococcosis are used to evaluate and differentiate the cardiac masses determined.…”

“…Electrocardiography showed nonspecific abnormalities of T-and Q-waves, RBBB and arrhythmias such ventricular tachycardia a rarely. [1][2][3][4][5][6] Dissection of the left ventricular free wall is also reported. 6 Echinococcal eggs are ingested by humans through contaminated foods and by close contact with infected animals.…”

“…2,4 Weinberg complement fixation, IgE to echinococcosis, and ELISA tests for echinococcosis are used to evaluate and differentiate the cardiac masses determined. 5 Since hydatid cyst in the right ventricle is usually subendocardial in location, the risk of cyst rupture into the ventricle is high. Invasion into the myocardial tissue occurs by coronary circulation or pulmonary cyst rupture in the pulmonary veins.…”

Epidemiology, clinical manifestations and diagnosis of zoonotic cestode infections: an update

“…The rupture of an hydatid cyst can cause an acute cardiac ischemic episode associated with a rise in serum cardiac enzymes (Ahmed et al 2002); it can also produce recurrent embolisms in the pulmonary arteries, pulmonary parenchyma, or peripheral circulation, for example in the thoracic aorta or thoracoabdominal aorta (Mayoussi et al 2002) or inferior vena cava (Karunajeewa et al 2002). Secondary hydatidosis, initially misdiagnosed as pulmonary metastases, was the consequence of a direct rupture of an hepatic hydatid disseminating into the inferior vena cava and causing pulmonary emboli (Smith et al 2001).…”

Surgical treatment of an Echinococcus cyst of the interventricular septum complicated by septic endocarditis, complete atrioventricular block, and rupture into the Valsalva sinus

“…As a rule, lung cysts occur less often than hepatic cysts. 2,3 The most dangerous complication of heart echinococcosis is cyst perforation, 4,5 with the frequency of intracardiac perforation being high (25%-40%). After cyst perforation, three-fourths of the patients die from septic shock or embolic complications.…”