Ruptured cardiac hydatid cyst as a rare cause of acute extremity ischemia: A case presentation

Abstract

Echinococcosis, also known as a Hydatic cyst (HC), is a chronic parasitic disease that is prevalent in countries where people consume infected grazing animal meat. The heart is involved in 0.5% to 2% of all hydatid cysts. The best diagnostic method for cardiac HC is echocardiography. In addition to radiological examinations, HC diagnosis is dependent on serological reactions such as the Cassoni test and ELISA for Echinococcus multilocularis. Rupture of cardiac HC from the left ventricle is an uncommon but potentially fatal consequence that results in ischemia by numerous emboli. We report a case of a 31year old Nepali male who presented in the emergency room (ER) with anaphylactic shock and lower and upper extremity ischemia. The patient was resuscitated in ER and then shifted to the Intensive Care Unit (ICU). The reperfusion of the lower and upper extremities was achieved after Fogarty embolectomy. To evaluate the source of the emboli, echocardiography was carried out, and a remnant of the ruptured cyst on the left ventricular free wall was found. The histopathology report came consistent with the HC. Accordingly, the patient received Albendazole. He preferred to seek a second opinion regarding the decided cardiac surgery in his home country Nepal.

Keywords

• Ruptured cardiac HC
• Embolism
• Lower limb ischemia
• Anaphylactic shock