[Primary echinococcus cyst of the heart. A case report]

A young male commercial pilot, completely asymptomatic of heart disease, was found to have an abnormal ECG on routine examination. This consisted of a bifascicular block (left anterior hemiblock plus a complete right bundle-branch block). Aviation regulations demanded further examination to rule out possible cardiac disease. On two occasions in 1984 and again in 1986 cardiac catheterisation was performed and revealed normal left ventricular function and normal coronary arteries. On 15 April 1986 an echocardiogram revealed a large cystic mass in the right ventricle, which was further delineated by right-sided cine-angiography. The patient was referred for cardiac surgery with the diagnosis of an Echinococcus cyst as the most likely possibility. Open-heart surgery was performed on 16 July 1986 and a 4 x 4 cm hydatid cyst, originating from the right ventricle septum and projecting into the right ventricular cavity, was removed. The diagnosis of Echinococcus granulosus was confirmed by histological examination.