Cardiac echinococcosis: echocardiographic diagnosis with a fatal clinical outcome
Al-Mahroos, H.M.; Garadah, T.S.; Aref, M.H.; Al-Bannay, R.A.
Saudi Medical Journal 26(11): 1803-1805
2005
ISSN/ISBN: 0379-5284 PMID: 16311670 Document Number: 592728
A 43-year-old woman presented to the emergency room with dry cough and shortness of breath [Bahrain]. On examination, she was cold and clammy, and had peripheral cyanosis, unrecordable blood pressure, tachycardia and a body temperature of 37.1 degrees C. Chest examination revealed a soft systolic murmur at the apex, and coarse crackles at the base of the right lung. Electrocardiography showed sinus rhythm with left bundle branch block. Chest x-ray showed mild cardiomegaly and a small opacity in the right lower lung lobe. Echocardiography revealed global hypokinesia with left ventricular ejection fraction of 30%, and moderate mitral and tricuspid regurgitation. A large calcific cystic mass measuring 7 cm x 5 cm was detected in the apex of the left ventricle and another cyst measuring 2 cm x 1.5 cm just above the posterior leaflet of the mitral valve. Despite inotropic support, the patient's conditioned worsened and she later arrested and expired after unsuccessful resuscitation. A diagnosis of echinococcosis affecting the heart was made.