PULMONARY-EMBOLISM DUE TO RIGHT-VENTRICUL AR HYDATIC CYST

BACKGROUND: The right ventricle is an exceptional localization for hyd atic cysts. There is a risk oi hydatic embolism and chronic or acute c or pulmonale. CASE REPORT: A 63-year-old man man with an uneventful hi story was hospitalized for dry cough, exercise-induced dyspnea and blo ody expectorations which had developed over the previous year. Multipl e and bilateral opacities were visualized on the standard chest x-ray and the right border of the heart showed a buldge in the middle portio n. Signs of right-sided hypertrophy were seen on the ECC. imaging find ings led to the diagnosis of multiple organ hydatiasis involving the l ung. the liver the mediastinum and a ruptured hydatic cyst in the righ t ventricle. The cavogram revealed defect images in the superior vena cave and the pulmonary angiogram confirmed the diagnosis of hydatic em bolism. Medical treatment was given but the patient died 8 months afte r diagnosis. DISCUSSION: Hydatic pulmonary embolism generally occurs a fter rupture of a hydatic cyst in the right ventricle or due to venous migration of daughter vesicles to the right heart then the pulmonary artery. Clinical manifestations are not specific although hemoptisy is the most frequent sign. Positive diagnosis, guided by echocardiograph ic findings, is based an the pulmonary arteriogram. Prognosis is parti cularly poor and depends of the patient's general status as well as th e number and size of the embolized vessels. Survival rate is poor. Ope n heart surgery is indicated in localized farms. (C) 1996, Massson. Pa ris.