Presentation
Dyspnea in a patient with previous history of cardiac surgery a few years prior for a cystic mass.
Patient Data
The CT scan demonstrates:
multiloculated cystic mass of the interventricular septum extending to the superior wall of the left ventricle and within the pulmonary trunk. Surgical clips are noted at the same level as well as midline sternotomy wires (history of surgery)
numerous cysts of various sizes are noted bilaterally within the distal main pulmonary arteries and their lobar, segmental and subsegmental branches
elevated left hemidiaphragm with triangular-shaped peripheral opacities of the left lower lobe suggestive of lung infarction secondary to pulmonary embolism
no associated lung or abdominal hydatid disease
Case Discussion
CT features of cardiac hydatid cyst centered on the interventricular septum with extensive pulmonary hydatid embolism in a patient with a previous history of cardiac surgery for hydatid cyst.
Cardiac involvement in hydatid disease is uncommon and accounts for about 0.5 to 2% of hydatidosis. The left ventricle is the most common location (about 60%). The interventricular septum is rarely involved (around 4% of cases). Both CT and MRI are helpful in precise the morphological features of the cysts as well as their location. CT is the best modality in the detection of wall calcification, whereas MRI depicts better the anatomical location as well as the internal and external components of the cysts. Surgery is the treatment of choice
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