BMJ Case Reports 2012; doi:10.1136/bcr-03-2012-6005
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A mysterious visitor to the heart

  1. Lorraine Dias2
  1. 1Department of Cardiology, Kasturba Medical College, Manipal, Karnataka, India
  2. 2Department of Internal Medicine, Kasturba Medical College, Manipal, Karnataka, India
  1. Correspondence to Dr G Vivek, vivekgraman{at}; vivekgraman{at}


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%. …

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