Cardiac hydatid disease and extracardiac organ involvement: A tertiary single-center experience

Abstract

Introduction: Cardiac involvement is rare in hydatid cyst disease, which accounted for 0.5%-2% of all hydatidosis cases. Cardiac cysts usually occur as part of a wider infestation with extracardiac involvement. This study aimed to describe the general characteristics, imaging findings, and range of organ involvement in cases of cardiac hydatid disease.Methods: Retrospective assessment of cardiac hydatid disease records, between 2007 and 2019, was undertaken to identify patients with cardiac hydatidosis. Hydatid cysts were assessed by transthoracic echocardiography, magnetic resonance imaging, and computed tomography. Clinical symptoms, treatment modalities, and follow-up were also evaluated.Results: Over the study period, 22 (13 males: 59.1%; mean age: 43.1 years; range: 12-63 years) patients with 24 cardiac hydatid cysts were identified. The most common symptom was chest pain, which occurred in 13 (59.1%) patients, Cardiac cysts were located in the left ventricle (n=10, 41.7%), right ventricle (n=5, 20.8%), interventricular septum (n=5, 20.8%), and pericardium (n=4, 16.7%). Extracardiac involvement was present in 14 (63.6%) patients, most commonly affecting the liver (n=10, 45.4%), but in 8 (36.3%) patients, there was no extracardiac organ involvement. Cardiac hydatid cysts were surgically removed in 20 (90.9%) patients.Conclusion: Cardiac hydatid disease is very uncommon, with the left ventricle as the most commonly affected structure in this series. Chest pain was the most common presenting symptom. Extracardiac involvement is common, so patients with cardiac hydatid cysts should be investigated for involvement of other organs.