Khush Bakht
RBH, United Kingdom
Abstract Title:
A Rare case – Cardiac hydatid disease
Biography:
I am a dedicated Medical Doctor with 5 years of NHS experience, beginning my career with an MBBS
from Ayub Medical College, Pakistan, in 2014. Since relocating to the UK in 2015, and gaining GMC
registration, I have built a robust career within the NHS, where I have served since 2019. My clinical
journey has spanned several medical specialties, including Emergency Medicine, Cardiology, Geriatric
Medicine, and Endocrinology, providing me with a versatile foundation in acute and chronic patient care.
Research Interests:
Hydatid disease is a zoonotic infection caused by the larval stage of Echinococcus, most
commonly involving the liver (65%) and lungs (25%). Cardiac involvement is rare, accounting
for approximately 1–2% of cases, with the left ventricle being the most frequently affected
site. Cardiac hydatid cysts are often asymptomatic but may present with chest pain, dyspnea,
palpitations, or life-threatening complications such as rupture, embolization, or anaphylaxis.
We report a rare case of a 15‑year‑old boy who presented with progressive shortness of breath on
exertion and gangrene of the right great toe. His past medical history was significant for hepatic
hydatid cystectomy one year prior. On examination, he was hypertensive and tachycardic.
Transthoracic echocardiography revealed a 3×3 cm cystic lesion within the left ventricular
cavity attached to the anterolateral wall, suggestive of a hydatid cyst. This was further confirmed
by computed tomography of the chest, which demonstrated a well‑defined cyst measuring
3.6×3.2×3.6 cm. Serology and FNAC were avoided due to the high risk of cyst rupture.
Additionally, Doppler ultrasound showed bilateral popliteal artery stenosis with occlusion of
the right posterior tibial and dorsalis pedis arteries, indicating peripheral embolization. The
patient underwent open heart surgery with excision of the left ventricular cyst along with
bilateral embolectomy. Intraoperatively, the cyst was located in the subendocardial layer of
the left ventricular lateral wall. Due to irreversible ischemia, right lower limb amputation was
performed.
This case highlights the rare occurrence of left ventricular hydatid cyst presenting with systemic
embolization leading to limb ischemia. Early diagnosis with echocardiography and CT imaging,
followed by prompt surgical intervention and adjunctive antihelminthic therapy, is crucial to
prevent fatal complications. Cardiac hydatid disease, though rare, should be considered in
endemic regions in patients with unexplained cardiac or embolic manifestations.
