An Incidental Finding of Heart Echinococcosis in a Patient with Infective Endocarditis: a Case Report

Dolina G. Gencheva 1 , 2 , Dimitar N. Menchev 3 , 4 , Dimitar K. Penchev 5 , 6  and Mariya P. Tokmakova 1 , 2
  • 1 Clinic of Cardiology, St George University Hospital, 66 Peshtersko Shose Blvd., 4002 Plovdiv, Bulgaria Bulgaria
  • 2 Section of Cardiology, Department of Internal Diseases, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
  • 3 Section of Nephrology, Department of Internal Diseases, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria Bulgaria
  • 4 Clinic of Nephrology, University Hospital “Kaspela”, Plovdiv, Bulgaria
  • 5 Section of Endoscopic Endocrine Surgery and Coloproctology, Department of Surgery, Faculty of Medicine, Sofia University «Sv. Kliment Ohridski», Sofia, Bulgaria Bulgaria
  • 6 Department of Endoscopic Endocrine Surgery and Coloproctology, Military Medical Academy Sofia, Bulgaria


Echinococcosis is a cosmopolitan zoonotic parasitic disease caused by infection with the larval stage of tapeworms from the Echinococcus genus, most commonly Echinococcus granulosus. According to WHO, more than 1 million people are affected by hydatid disease at any time.1 About 10% of the annual cases are not officially diagnosed.2 In humans, the disease is characterized by development of three-layered cysts. The cysts develop primarily in the liver and the lungs, but can also affect any other organ due to the spreading of the oncospheres. Cardiac involvement is very uncommon - only about 0.01-2% of all cases.4,5 In most cases, the cysts develop asymptomatically, but heart cysts could manifest with chest pain, dyspnea, cough, hemophtisis and can complicate with rupture. Diagnosis is based on a number of imaging techniques and positive serological tests. Treatment for cardiac localization is almost exclusively surgical.

We present a case of an incidental finding of an echinococcal cyst in the left atrium (rarest possible localization of heart echinococcosis) in a patient, admitted for infective endocarditis.

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