A25-year-old male presented with dyspnea of 6 months duration. Physical examination revealed muffled heart sounds. Electrocardiogram was normal.
Journal of the American College of Cardiology Ó 2013 by the American College of Cardiology Foundation Published by Elsevier Inc.
Vol. 62, No. 16, 2013 ISSN 0735-1097/$36.00 http://dx.doi.org/10.1016/j.jacc.2013.04.103
IMAGES IN CARDIOLOGY
Giant Cardiac Hydatid Cyst An Uncommon Cause of Cardiomegaly Nagaraja Moorthy, DM,* Rajiv Ananthakrishna, DM,* Ravindran Rajendran, MD,* Girish S. L. Gowda, MCH,y Seetharama P. S. Bhat, MCH,y Manjunath C. Nanjappa, DM* Bangalore, India
From the *Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, India; and the yDepartment of Cardiothoracic and Vascular Surgery, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, India. Manuscript received April 8, 2013; accepted April 19, 2013.
25-year-old male presented with dyspnea of 6 months duration. Physical examination revealed muffled heart sounds. Electrocardiogram was normal. Chest x-ray in posteroanterior view showed cardiomegaly and upturned apex (A). In the lateral view, a dense well demarcated opacity (arrow) was seen between cardia and dome of diaphragm (B). Transthoracic and transesophageal echocardiography revealed multiple cysts in the usual cardiac location, giving a honeycomb appearance (C, Online Video 1) and suggestive of hydatid cyst. The cardiac chambers could not be visualized on echocardiography. Cardiac magnetic resonance imaging revealed a giant hydatid cyst with multiple daughter cysts within it, occupying intrapericardial space with marked cephalad and posterolateral displacement of cardiac chambers (D and E; Online Videos 2 and 3). The cyst measured 10 11 12 cm. During surgery, more than 200 daughter cysts were removed along with debris (F). Pericardial involvement in hydatid cyst disease is rare. We highlight intrapericardial echinococcosis presenting as cardiomegaly on chest radiograph.
A
