Cardiac tamponade by hydatid pericardial cyst: a rare echocardiography image

A 19-year-old previously healthy woman originaly from the countryside of Morocco presented to our emergency department with dyspnea chest discomfort and hypotension. She reported a 1-month history of fever and abdominal pain. On physical examination her heart sounds were rhythmic but muffled, and there was an audible pericardial friction rub. Her EKG showed sinus tachycardia with low voltage. Two-dimensional transthoracic echocardiography revealed large pericardial effusion with the presence of round formations in the pericardial space suggestive of hydatid cysts (A). Abdominal CT showed rupture of a hepatic hydatid cyst into the pericardial space through a transdiaphragmatic fistula. Diagnostic of Cardiac tamponade by hydatid pericardial cyst: was confirmed. The patient underwent urgent surgical drainage of her pericardial effusion and was medically treated with albendazole. Unfortunately she died 2 days after her surgery.