Successful Pregnancy in Chronic Obstructive Pulmonary Hypertension Secondary to Pulmonary and Cardiac Hydatid Cysts: A Case Report
-
Farnaz Ahmadi
,
Raha Parnia
,
Bahamin Astani
,
Mohammad-Sadegh Keshmiri
,
Shakiba Khodadad
,
Hakimeh Sheikhzadeh
,
Zahra Daneshmandi
,
Faezeh Ansari
,
Mahsa Riahi
,
Sima Noorali
,
Hannaneh Yousefi-Koma
,
Babak Sharif-Kashani
,
Shadi Shafaghi
Abstract
Background: Pregnancy in women with pulmonary hypertension (PH) is contraindicated because of high mortality rates associated with physiological changes, particularly in the peripartum and postpartum periods. Termination is recommended early if pregnancy occurs. Consequently, clinical experience with continued pregnancy in patients with PH is scarce.
Case Presentation: A 31-year-old woman was diagnosed with multiple bilateral pulmonary and right ventricular hydatid cysts. After surgical and pharmacologic treatments, she developed PH due to pulmonary artery obstruction 8 years later. Because of her condition, she was ineligible for surgery and received medical therapy, including tadalafil, bosentan, and eplerenone. After 3 years, she conceived despite advice to avoid pregnancy. At 37 weeks’ gestation, she underwent successful emergency cesarean delivery because of maternal dyspnea and tachycardia.
Conclusion: Prompt treatment and regular follow-up in a tertiary care center using a multidisciplinary approach are crucial for managing pregnant patients with PH.
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19. Oraha AY, Faqe DA, Kadoura M, Kakamad FH, Yaldo FF, Aziz SQ. Cardiac Hydatid cysts; presentation and management. A case series. Ann Med Surg (Lond). 2018;30:18-21.
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21. Wadhawa V, Shah J, Doshi C, Ramani J, Lakhia K, Rathod D, et al. Surgical overview of cardiac echinococcosis: a rare entity. Interact Cardiovasc Thorac Surg. 2018;27(2):191-7.
22. Martin SR, Edwards A. Pulmonary Hypertension and Pregnancy. Obstet Gynecol. 2019;134(5):974-87.
23. Bayaroǧullari H, Davran R, Çavuş Y, Yetim TD, Evirgen Ö. Liver hydatid cyst leading to bilateral pulmonary artery embolism and bilateral multiple pulmonar echinococcosis via inferior vena cava: report of a case. Clin Imaging. 2013;37(2):374-8.
24. Muller BA, Diab KA. Pulmonary hypertension in pregnancy and its effects on the fetus. Semin Fetal Neonatal Med. 2022;27(4):101348.
25. De Marco T. Pulmonary arterial hypertension and women. Cardiol Rev. 2006;14(6):312-8.
26. Cheron C, McBride SA, Antigny F, Girerd B, Chouchana M, Chaumais MC, et al. Sex and gender in pulmonary arterial hypertension. Eur Respir Rev. 2021;30(162):200330.
27. Yang JZ, Fernandes TM, Kim NH, Poch DS, Kerr KM, Lombardi S, et al. Pregnancy and pulmonary arterial hypertension: a case series and literature review. Am J Obstet Gynecol MFM. 2021; 3(4):100358.
28. Meng ML, Landau R, Viktorsdottir O, Banayan J, Grant T, Bateman B, et al. Pulmonary Hypertension in Pregnancy: A Report of 49 Cases at Four Tertiary North American Sites. Obstet Gynecol. 2017;129(3):511-20.
29. Dias A, Mineiro A, Pinto L, Lança F, Plácido R, Lousada N. Pregnancy and Pulmonary Arterial Hypertension: A Case Report. Open Respir Arch. 2021;3(4):100135.
2. Ahmed HA, Almasoudi EA, Hetaimish BM, Samargandi R. Primary Hydatid Cyst of the Thigh: Atypical Location and Perioperative Strategies to Minimize Recurrence After Accidental Cyst Rupture. Cureus. 2023 Aug 3;15(8):e42915.
3. Chaya D, Parija SC. Performance of polymerase chain reaction for the diagnosis of cystic echinococcosis using serum, urine, and cyst fluid samples. Trop Parasitol. 2014;4(1):43-6.
4. Dursun M, Terzibasioglu E, Yilmaz R, Cekrezi B, Olgar S, Nisli K, et al. Cardiac hydatid disease: CT and MRI findings. AJR Am J Roentgenol. 2008 ;190(1):226-32.
5. Oueslati S, Saïd W, Saaidi I, Djebbi M, Charrada L, Rezgui L, et al. Imagerie du kyste hydatique du coeur. A propos de 8 observations [Imaging cardiac hydatid cysts: 8 cases]. Presse Med. 2006;35(7-8):1162-6. French.
6. Jamli M, Cherif T, Ajmi N, Besbes T, Mgarrech I, Jerbi S, et al. Surgical Management and Outcomes of Cardiac and Great Vessels Echinococcosis: A 16-Year Experience. Ann Thorac Surg. 2020;110(4):1333-8.
7. Kankilic N, Aydin MS, Günendi T, Göz M. Unusual Hydatid Cysts: Cardiac and Pelvic-Ilio femoral Hydatid Cyst Case Reports and Literature Review. Braz J Cardiovasc Surg. 2020;35(4):565-72.
8. Kosecik M, Karaoglanoglu M, Yamak B. Pericardial hydatid cyst presenting with cardiac tamponade. Can J Cardiol. 2006;22(2):145-7.
9. El Kharras A, Atmane M, El Fenni J, Chaouir S, Amil T. [Cardiac and renal hydatid disease--contribution of imaging: report of a case]. Pan Afr Med J. 2014;18:153.
10. El Majhad A, Lachhab A, Cherradi R, Srairi J, Srairi N, Doghmi N et al. [The contribution of magnetic resonance imaging (MRI) in the diagnosis of cardiac hydatid cyst]. East Mediterr Health J. 2011;17(12):996-1000. French.
11. Miralles A, Bracamonte L, Pavie A, Bors V, Rabago G, Gandjbakhch I, et al. Cardiac echinococcosis: Surgical treatment and results. J Thorac Cardiovasc Surg. 1994;107(1):184-90.
12. Aili A, Peng L, Zhang J, Liu Y, Peng L, Yi Q, et al. Hydatid Pulmonary Embolism: A Case Report and Literature Review. Am J Case Rep. 2021;22:e934157.
13. Ogul H, Topcu S, Aydin Y, Ulas AB, Kantarci M, Eroglu A. An Unusual Cause of Pulmonary Arterial Hypertension: Hydatid Cyst. Ann Thorac Surg. 2020;109(4):e267–9.
14. Afify H, Kong A, Bernal J, Elgendy IY. Pulmonary Hypertension in Pregnancy: Challenges and Solutions. Integr Blood Press Control. 2022;15:33-41.
15. Bulman W, Coyle CM, Brentjens TE, Horn EM, Dickstein ML, Wilt JS, et al. Severe Pulmonary Hypertension Due to Chronic Echinococcal Pulmonary Emboli Treated with Targeted Pulmonary Vascular Therapy and Hepatic Resection. Chest. 2007;132(4):1356-8.
16. El Boussaadani B, Regragui H, Bouhdadi H, Wazaren H, Ajhoun I, Laaroussi M, et al. Primary cardiac hydatid cyst presenting with massive pericardial effusion: a case report. Egypt Hear J. 2020;72(1):51.
17. Ghrairi H, Khouadja MA, Abouda M, Ammar J, Hantous S, Kilani T, et al. [Hydatid cyst of the heart and vessels, four cases]. Presse Med. 2005;34(2 Pt 1):101-4.
18. Rhissassi J, Bouhdadi H, Wazaren H, El aamadi W, Bouchikh M, Laaroussi M. Incidental finding of multiple pulmonary and cardiac hydatid cysts. Ann Cardiol Angeiol (Paris). 2021;70(2):122-4.
19. Oraha AY, Faqe DA, Kadoura M, Kakamad FH, Yaldo FF, Aziz SQ. Cardiac Hydatid cysts; presentation and management. A case series. Ann Med Surg (Lond). 2018;30:18-21.
20. Moraes RP, Brida MS, Reis RM, Silva RS, Farias CB. Cardiac Hydatid Cyst: An Uncommon Cause of Complete Atrioventricular Block. Arq Bras Cardiol. 2023;120(5):e20220597. English, Portuguese.
21. Wadhawa V, Shah J, Doshi C, Ramani J, Lakhia K, Rathod D, et al. Surgical overview of cardiac echinococcosis: a rare entity. Interact Cardiovasc Thorac Surg. 2018;27(2):191-7.
22. Martin SR, Edwards A. Pulmonary Hypertension and Pregnancy. Obstet Gynecol. 2019;134(5):974-87.
23. Bayaroǧullari H, Davran R, Çavuş Y, Yetim TD, Evirgen Ö. Liver hydatid cyst leading to bilateral pulmonary artery embolism and bilateral multiple pulmonar echinococcosis via inferior vena cava: report of a case. Clin Imaging. 2013;37(2):374-8.
24. Muller BA, Diab KA. Pulmonary hypertension in pregnancy and its effects on the fetus. Semin Fetal Neonatal Med. 2022;27(4):101348.
25. De Marco T. Pulmonary arterial hypertension and women. Cardiol Rev. 2006;14(6):312-8.
26. Cheron C, McBride SA, Antigny F, Girerd B, Chouchana M, Chaumais MC, et al. Sex and gender in pulmonary arterial hypertension. Eur Respir Rev. 2021;30(162):200330.
27. Yang JZ, Fernandes TM, Kim NH, Poch DS, Kerr KM, Lombardi S, et al. Pregnancy and pulmonary arterial hypertension: a case series and literature review. Am J Obstet Gynecol MFM. 2021; 3(4):100358.
28. Meng ML, Landau R, Viktorsdottir O, Banayan J, Grant T, Bateman B, et al. Pulmonary Hypertension in Pregnancy: A Report of 49 Cases at Four Tertiary North American Sites. Obstet Gynecol. 2017;129(3):511-20.
29. Dias A, Mineiro A, Pinto L, Lança F, Plácido R, Lousada N. Pregnancy and Pulmonary Arterial Hypertension: A Case Report. Open Respir Arch. 2021;3(4):100135.
| Files | ||
| Issue | Vol 21 No 1 (2026) | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/jthc.v21i1.21288 | |
| Keywords | ||
| Case Report Heart Hydatid Cyst Lung Pregnancy Pulmonary Hypertension | ||
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How to Cite
1.
Ahmadi F, Parnia R, Astani B, Keshmiri M-S, Khodadad S, Sheikhzadeh H, Daneshmandi Z, Ansari F, Riahi M, Noorali S, Yousefi-Koma H, Sharif-Kashani B, Shafaghi S. Successful Pregnancy in Chronic Obstructive Pulmonary Hypertension Secondary to Pulmonary and Cardiac Hydatid Cysts: A Case Report. Res Heart Yield Transl Med. 2024;21(1):111-115.
