Syncope in a patient with a large left ventricular hydatid cyst: An unusual presentation

Abstract

Cardiac echinococcosis is one of the rare manifestations of hydatid disease that could be a serious and a life-threatening problem. The left ventricle is the most frequent site of the cardiac involvement. Hence cysts tend to grow towards the epicardium frequently, and they grow slowly; most of the cases have large and often asymptomatic cysts in their heart [1,2]. In this case report, we present a 72-year-old woman who was referred to our department complaining of palpitation with history of two syncopal attacks. The patient was finally diagnosed to have a large left ventricular hydatid cyst and underwent successful surgical excision. A 72-year-old Iranian woman with a history of hypertension was referred to our department for investigation of left hemithoracic mass. On admission she was complaining of palpitation and a vague resting chest discomfort. She had a history of two syncopal episodes in last month with a week interval. A plain chest roentgenogram done before referral to our hospital had revealed a large paracardiac mass on left hemithorax. At clinical examination, the patient was afebrile. The heart rate was 96 beats/min and the blood pressure was 130/ 70 mm Hg. Cardiac and chest auscultation was uncharacteristic. There was no organomegaly and abdominal examination was unremarkable. Neurological examination revealed no abnormalities aswell. The electrocardiogram showed T-wave inversion in leads I, II, aVL, V5, and V6. Computed tomography (CT) scan (Fig. 1) revealed a large paracardiac cystic mass in the left hemithorax with the possible origin of the lower lobe of the left lung or the heart. Transthoracic echocardiography (TTE) was also performed, showing a large cystic mass in the lateral wall of the