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Echinococcal cyst mimicking myocardial infarction
  1. M Derntl,
  2. J Bergler-Klein,
  3. I M Lang

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A 36 year old woman presented with a history of palpitations and tachycardia over the preceding two weeks. Physical examination was normal and all laboratory tests were unremarkable. However, electrocardiography revealed classical signs of subacute inferior myocardial infarction. Coronary angiography demonstrated normal coronary arteries. A left ventriculogram (panel A) showed a 6 × 4 cm cystic lesion with a rim of calcification adherent to the inferior myocardial wall, without impairment of regional wall motion. Echocardiography (panel B) showed an intramyocardial invasion of the cyst into the basal interventricular septum, but no direct communication with cardiac chambers. No additional cysts could be identified. The cardiac cyst was surgically removed through a median sternotomy. Histopathological analysis was diagnostic for Echinococcus granulosus. The patient’s postoperative course was uneventful. She was discharged on albendazole and was doing well one year after the procedure.

Cardiac hydatid disease is rare. When the cysts have an intramyocardial component, the interventricular septum is a common location.

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