[Symptomatology of hydatid cyst of the heart. Study of a continuous series of 13 cases and value of x-ray computed tomography].

Thirteen consecutive cases of cardiac hydatic cyst were studied. The cysts were usually multiple, predominantly left ventricular. There were two cases of rupture of left ventricular cysts with systemic embolism, and three ruptures of right ventricular cysts causing pulmonary embolism. The average age of the patients was 31 years: 12 patients lived in regions where hydatid disease was endemic. Other localisations of hydatic disease were found in 7 cases. Two patients were completely asymptomatic. Three patients presented with a tumoral syndrome. The presentation was atypical simulating coronary artery disease in 2 cases, valvular heart disease in 2 cases, pericarditis in 2 cases and bronchopneumonia in 3 cases. The electrocardiogramme showed sinus rhythm in all cases and changes of subepicardial ischaemia in 8 cases and acute cor pulmonale in 3 cases. Chest X-ray showed a localised deformation of the cardiac silhouette in 5 cases and calcification in 4 cases. Direct angiocardiographic signs were present in 2 out of 8 cases; usually there was an indirect image of endocavitary filling defect. The tumour was demonstrated by 2D echocardiography in the three most recent cases. The value of CAT was assessed in the last 2 cases: it was absolutely diagnostic in 1 case of septal localisation. The results were poor in the second case due to the presence of mitral calcification. Twelve patients underwent surgery; there were 3 deaths due to rupture and 1 death before surgery. The clinical presentation of cardiac hydatid disease is very variable and the diagnosis is difficult.(ABSTRACT TRUNCATED AT 250 WORDS)