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Year : 2011  |  Volume : 14  |  Issue : 1  |  Page : 58-59
Computerized tomographic coronary angiography in diagnostics of cardiac echinococcus


Department of Cardiovascular and Thoracic Surgery, University Hospital of Thessaly, Larissa, Greece

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Date of Web Publication31-Dec-2010
 

How to cite this article:
Karangelis D, Tagarakis GI, Tsantsaridou A, Tsilimingas N. Computerized tomographic coronary angiography in diagnostics of cardiac echinococcus. Ann Card Anaesth 2011;14:58-9

How to cite this URL:
Karangelis D, Tagarakis GI, Tsantsaridou A, Tsilimingas N. Computerized tomographic coronary angiography in diagnostics of cardiac echinococcus. Ann Card Anaesth [serial online] 2011 [cited 2021 Oct 20];14:58-9. Available from: https://www.annals.in/text.asp?2011/14/1/58/74403


Cardiac localization of echinococcus, although quite rare, is a potentially serious complication of hydatid disease. [1,2] Here, we present a unique case of a 35-year-old Greek female patient with a 6-month anamnesis of angina pectoris and rhythm disturbances on electrocrdiogram, without cardiac enzymes mobilization. Plain chest X-ray showed no pathologies. A coronary computerized tomographic (CT) angiography revealed an enormous cyst (approximately 15 cm in diameter) [Figure 1] and [Figure 2]. The patient was also submitted to transthoracic echocardiography, which revealed a cystic formation compressing right cardiac cavities [Figure 3]. The advantages of CT angiography over echocardiography can be summed up to the following: (i) it offers better visualization of the structure and (ii) it provides crucial information regarding the status of the coronary arteries which is particularly important prior to a cardiothoracic operation, especially if the procedure is performed on attendance of extracorporeal circulation. The patient underwent a median sternotomy and a complete enucleation of the cyst was performed without the need for cardiopulmonary bypass. The serology for echinococcus granulosus antibody was positive and confirmed the diagnosis.
Figure 1 :Image of coronary CT angiography indicating the location of the echinococcus cyst between the lower cardiac pole and diaphragm with infiltrations in the pericardium and signs of right ventricular and lower vena cava compression. The superficial course of the coronary vessels (left anterior descending and right coronary artery can also be seen). At the apex of the heart, the merging of the left anterior descending and the right posterior descending artery (branch of the coronary artery) is clearly visible (right-hand side of the figure)

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Figure 2 :A CT image of the echinococcus cyst captured at a level below the cardiac silhouette with a clear, measured vision of its large proportions

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Figure 3 :An echocardiography image showing the cystic structure with compressing phenomena of the right cardiac cavities

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   References Top

1.Kelle S, Kφhler U, Thouet T, Fleck E, Nagel E. Cardiac involvement of Echinococcus granulosus evaluated by multi-contrast CMR imaging. Int J Cardiol 2009;131:e59-60.   Back to cited text no. 1
    
2.Kopp CW, Binder T, Grimm M, Merl O, Thalhammer F, Ullrich R, et al. Images in cardiovascular medicine. Left ventricular echinococcosis with peripheral embolization. Circulation 2002;106:1741-2.  Back to cited text no. 2
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Correspondence Address:
Dimos Karangelis
Georgiou Rika 4, Larissa
Greece
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.74403

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    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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