DEPT. OF CARDIOTHORACIC SURGERY, SHAHEED RAJAEE CARDIOVASCULAR MEDICAL CENTER, MELLAT PARK, VALI ASR AVE., TEHRAN, IRAN
Background: Cardiac involvement in hydatid disease is uncommon (<2%). Symptoms depend on the location, size and integrity of cyst and the patients may be asymptomatic or in profound circulatory collapse.
Method: In this descriptive, cross-sectional study from March 1992 to July 2003, we had 13 proved cardiac hydatid cysts in our center. We evaluated clinical signs, symptoms, diagnostic procedures and treatment results of these patients.
Results: Average age of the patients was 36±3.2 years, 61.5% were female and 38.5% were male.
Dyspnea was the most common symptom; followed by dysrrhythmia. Inverted T- wave and widening of QRS complex existed in 30%. Cardiomegaly was seen in 61%. Echocardiography showed cystic lesion in all cases. The most common sites of cardiac involvement were interventricular septum (46%), followed by right atrium (15.3%), LV free wall (15.3%), pericardium (7.7%), RV free wall (7.7%), and left atrium (7.7%). We used hypertonic saline solution for evacuation of fluid cyst. IABP insertion was used in 15.3%. Permanent pacemaker insertion was used in 7.7%. Hospital mortality was 7.7%.
Conclusion: There are a wide range of clinical signs and symptoms of cardiac hydatid disease depending on the site, size and shape of the cyst. There was not any advantage for CT-scan compared to echocardiography. Because Iran is an endemic area for hydatid disease, cardiac involvement should be a differential diagnosis of any cardiovascular symptom.