The silent invader: a case of intrapericardial hydatid cyst with exceptional pulmonary artery involvement

A 70-year-old woman was referred to our cardiology department for the management of dyspnoea. Cardiovascular examination revealed a loud P2, with no sign of right-sided heart failure. Chest X-ray showed a convex left medium cardiac border and a double contour along the right cardiac border. Transthoracic echocardiogram revealed a cystic mass attached to the right ventricle apex. Computed tomography scan showed cyst with fluid density on the apex of the right ventricle; and a honeycomb-like aspect cyst with partial occlusion in the left pulmonary artery. Cardiac magnetic resonance imaging revealed the presence of hydatic intrapericardial cyst that compresses the right ventricular apex; associated with intraluminal left pulmonary artery cyst. Hydatic serology was positive. The patient refused surgery and was discharged on a regimen of Albendazole. She has been followed up closely with a good outcome.