Papagna D, Aloe M A, Spagnolo S
Servizio di Cardiologia, Ospedale S. Martino, Genova.
G Ital Cardiol. 1991 Oct;21(10):1129-33.
The authors report a case of hydatid cyst of the ventricular septum. The patient, an asymptomatic 30-year-old woman, was hospitalized in the Department of Pneumology after a routine chest X-ray test which detected two round masses in the lungs. During hospitalization the patient was asymptomatic and standard ECG was normal, but two-dimensional echocardiography (2D echo) revealed a cardiac cyst localized in the mediobasal portion of the ventricular septum. The finding was confirmed by computed tomography and nuclear magnetic resonance imaging. An echinococcosis was suspected on the basis of the patient's origin (Morocco) and because of the presence of cystic lesion also in the lungs, and was confirmed by positive hemagglutinin test. The patient underwent surgery (suction of cardiac cyst in extracorporeal circulation and washing with formaline 2%). This case is of particular interest because of the rarity of cardiac localization of echinococcosis (0.02-2%) and the lack of symptoms or of asymptomatic cardiac arrhythmias despite the location in the ventricular septum. Patients with hepatic or pulmonary hydatid disease could be routinely investigated by 2D echo because this imaging technique is: noninvasive, feasible and has a high sensitivity for detecting intracardiac echinococcal cysts.
作者报告了一例室间隔包虫囊肿病例。患者为一名30岁无症状女性,在常规胸部X线检查发现肺部有两个圆形肿块后入住呼吸科。住院期间患者无症状,标准心电图正常,但二维超声心动图(2D回声)显示心脏囊肿位于室间隔的中基底部。计算机断层扫描和核磁共振成像证实了这一发现。基于患者的籍贯(摩洛哥)以及肺部也存在囊性病变,怀疑为棘球蚴病,并通过血凝试验阳性得到证实。患者接受了手术(体外循环下抽吸心脏囊肿并用2%甲醛冲洗)。该病例特别引人关注,因为棘球蚴病心脏定位罕见(0.02 - 2%),且尽管位于室间隔,但患者无症状或无无症状性心律失常。患有肝或肺包虫病的患者可常规通过二维超声心动图进行检查,因为这种成像技术具有无创、可行且对检测心内棘球蚴囊肿具有高敏感性的特点。