CHRONIC HEART PULMONALE DUE TO HYDATID EM BOLISMS COMPLICATING AN HEPATIC HYDATID CYST

An hydatid cyst of the left lobe of the liver, associated with right h eart failure, was diagnosed in a 61-year-old man presenting with dyspn oea. Doppler echocardiography combined with cardiac catheterization de monstrated the presence of pulmonary precapillary hypertension. Pulmon ary perfusion scintigraphy with Technetium-labelled albumin microspher es demonstrated multiple pulmonary embolisms, leading to a diagnosis o f postembolic chronic cor pulmonale. Due to the absence of thrombophle bitis and ultrasound signs of an intracaval hydatid membrane, floating at the level of the cyst of the left robe of the liver, the diagnosis of parasitic postembolic chronic heart pulmonale, due to fistulizatio n of an hepatic hydatid cyst into the inferior vena cava, was establis hed. Only chemotherapy was proposed in this patient due to disseminati on of the hydatid material in the lungs.