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(Circulation. 2000;101:1352.)
© 2000 American Heart Association, Inc.

Images in Cardiovascular Medicine

Cardiac Echinococcosis

Guilherme R. Maffeis, MD; Orlando Petrucci, MD; Rosana Carandina, MD; Cid A. Leme, Jr, MD; Márcio Truffa, MD; Reinaldo Vieira, MD, PhD; Fernando Schelini, MD; Konradin Metze, MD, PhD; Eduardo A. Nogueira, MD, PhD

From the University of Campinas School of Medicine, Campinas, São Paulo, Brazil.

Correspondence to Eduardo A. Nogueira, MD, PhD, Department of Internal Medicine, Division of Cardiology, University of Campinas School of Medicine, Cidade Universitaria Zeferino Vaz, Barão Geraldo, 13083–970 Campinas, São Paulo, Brazil.

A57-year-old man was admitted to our University Hospital with a diagnosis of ischemic stroke. He had no antecedent illnesses. He had been a shepherd for 10 years. Physical examination disclosed an aphasic man with complete right hemiparesis and no other remarkable sign. Chest radiograph showed the left heart border to be lobulated and partially calcified (Figure 1). Cranial CT disclosed hypodense areas in the right cerebellar hemisphere and the left temporoparietal and left frontal regions. An ECG revealed T-wave inversion in leads V₄ through V₆. Cardiac MRI revealed an infiltrated cystic mass in the anteroapical region of the left ventricle (Figure 2), in accordance with the transesophageal echocardiogram (Figure 3). Cardiac catheterization and angiocardiography revealed normal coronary arteries and a calcified cystic mass in the anteroapical wall (Figure 4). With a diagnosis of echinococcosis, the patient was referred to cardiac surgery for resection of the mass. At operation, a multicystic mass involved the anteroapical wall of the left ventricle, with adhesions to the pericardium (Figure 5). The endocardial aspect was protruding inside the cavity, but it was smooth. The postoperative period was uneventful. Analysis of the resected specimen revealed multiple hydatid cysts with live scolices of Echinococcus granulosus. After therapy with albendazol (5 cycles of 30 days [10 mg · kg^-1 · d^-1] with rest periods of 2 weeks between the cycles), the patient has remained well.

View larger version (146K): [in this window] [in a new window]   Figure 1. Chest radiograph disclosing a lobulated and calcified left heart border at and above apex.

View larger version (98K): [in this window] [in a new window]   Figure 2. Cardiac . . . [Full Text of this Article]

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