Cardiac MRI Reveals Multiple Pericardial Hydatid Cysts in Asymptomatic Patient

Introduction

Pericardial hydatid cysts are among the rarest manifestations of echinococcosis, and their detection in an asymptomatic individual is even more uncommon. This case report explores how Cardiac Magnetic Resonance Imaging (CMR) played a pivotal role in diagnosing multiple pericardial cysts in a 70-year-old woman, ultimately guiding timely surgical intervention.
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A Rare and Revealing Diagnosis

Hydatid disease is typically associated with liver and lung involvement. However, cardiac hydatid cysts—especially pericardial ones—account for less than 2% of all cases.

Key Highlights:

• Patient Profile: 70-year-old asymptomatic female farmer.
• Initial Screening: Normal ECG and unremarkable blood tests.
• TTE Findings: Roundish formations adjacent to the left ventricular wall.
• CMR Revelations: Multiple large pericardial cysts with no gadolinium enhancement—hallmarks of hydatid cysts.

A detailed analysis can be found in our main journal article.

The Clinical Significance of Early Imaging

Though asymptomatic, pericardial hydatid cysts carry a serious risk of rupture, potentially leading to septic shock or cardiac tamponade. Therefore, imaging is not only diagnostic but lifesaving.

The American Heart Association (AHA) underscores the importance of early detection and imaging in managing rare cardiac conditions, reinforcing the critical role of tools like CMR in clinical settings

Why CMR Made the Difference

Cardiac Magnetic Resonance Imaging offered superior tissue characterization and visualization:

• Multiplanar imaging without ionizing radiation.
• High-resolution contrast for liquid-based cyst components.
• Identified subtle interference with heart wall motion.
• Confirmed diagnosis when serological tests were inconclusive.

This case affirms that while transthoracic echocardiography (TTE) remains the first-line tool, CMR can be the decisive modality in rare presentations.

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Surgical Outcome and Patient Recovery

Following the diagnosis, the patient underwent successful surgical excision of the cysts. Histopathology confirmed the presence of Echinococcus granulosus, validating the radiological diagnosis. This case emphasizes the importance of a multidisciplinary approach in such rare cardiac presentations.

Read the full study at: https://doi.org/10.29328/journal.jccm.1001146

Key Takeaways

• Cardiac hydatid cysts are rare but potentially fatal.
• CMR provides invaluable diagnostic insights when traditional tests fail.
• Asymptomatic patients from endemic regions should undergo careful evaluation.

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