A mysterious visitor to the heart

Shetty, Ranjan and Vivek, G and Nayak, Satish and Dias, Lorraine Simone (2012) A mysterious visitor to the heart. BMJ Case Reports . pp. 1-2.

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A 55-year-old man with a history of hypertension was admitted with complaints of progressive breathlessness of 2 months duration. General physical examination was remarkable for an elevated jugular venous pressure and bilateral pedal oedema. His ECG showed normal axis, left ventricular hypertrophy by voltage criteria and associated left atrial enlargement. Echocardiogram (ECHO) revealed multiple, mobile, hyperechoic masses with central lucency in the left ventricle (LV) attached to the apex, septum and free wall. The cyst wall had double echogenic lines separated by a hypoechogenic layer suggestive of hydatid cyst disease (figure 1).1 In addition, his LV was globally hypokinetic with an ejection fraction (EF) of 25%. CT of the chest with contrast showed non-calcified, hypointense masses surrounded by a high-attenuation wall, in the LV cavity which was consistent with hydatid cyst (figure 2).1 No hepatic cysts could be demonstrated. ELISA for the detection of anti-Echinococcus antibodies (IgG) in serum was negative. Coronary angiogram showed no significant obstructive lesions. Surgical removal of the cysts was planned. Preoperatively he was started on oral albenadazole 400 mg twice a day. Repeat ECHO after 5 days showed significant resolution of the cysts; surgery was deferred. The cysts completely resolved with 1 month of albenadazole therapy alone. His LVEF had improved to 40% at follow-up.

Item Type: Article
Subjects: Medicine > KMC Manipal > Cardiology
Medicine > KMC Manipal > Medicine
Depositing User: KMC Manipal
Date Deposited: 28 Dec 2012 04:13
Last Modified: 28 Dec 2012 04:13
URI: http://eprints.manipal.edu/id/eprint/77745

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