PMC7756595_01
Computed tomography of the chest: (a) axial; (b) coronal; (c) sagittal demonstrating a well-defined interventricular hypodensity protruding into the right ventricle and right atrium (arrows).
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In addition to the pulmonary HD findings, the chest CT also demonstrated a hypodensity within the IVS, resulting in partial effacement of the right ventricle and a finger-like protrusion of the hydatid cyst into the right atrium (Figure 1).
(a) Two- and three-dimensional transoesophageal echocardiography view of the heart at the mid-oesophageal level showing infiltration of the entire interventricular septum (open white arrow) by the hydatid cyst and reduction of the right ventricle to a slit-like cavity. (b) The hydatid cyst protrudes into the right atrium without causing tricuspid valve dysfunction. (c and d) Two-dimensional transoesophageal echocardiography trans-gastric view showing infiltration of the interventricular septum by the hydatid cyst (solid white arrow) and its relation to the tricuspid valve (open arrow, c). Deep trans-gastric view depicting septal hypertrophy due to hydatid disease (white arrow) mimicking asymmetrical septal hypertrophic cardiomyopathy (d). (e and f) Three-dimensional echocardiographic reconstruction of the right atrium (RA) and right ventricle (RV) showing the anterior location of the hydatid cyst protruding into the right atrium (white arrow) relative to the tricuspid valve (black arrow) at the base of the heart (e), and unobstructed blood flow through the tricuspid valve (white arrow) (f).
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TOE confirmed an infiltrating cystic lesion involving the IVS, resulting in expansion of the IVS towards the right ventricle with partial effacement of the right ventricle into a slit-like cavity and protrusion of the cystic lesion into the right atrium without tricuspid valve dysfunction. The cyst demonstrated mixed echogenicity and calcified components (Figure 2).