Chest pain with dyspnoea ...

A 38-year-old lady was admitted to our hospital with haemoptysis followed by chest pain, breathlessness, and low-grade fever. There was a history of rearing pet animals. On clinical evaluation, no abnormal findings were detected. Her haematological and biochemical parameters were within normal limits except the ELISA test for Echinococcus granulosus, which was positive.

 

Examination

Electrocardiogram (ECG) showed T-wave inversion in V2, V3, V4, and V6. The chest radiography showed a well-defined lesion in the right lower zone of the lung with a normal cardiac silhouette (Figure 1). Ultrasonography of the abdomen was normal. Two-dimensional echocardiography showing a lesion measuring 2 × 1.8 cm cystic mass was noted at the apex (intramyocardial). Chest high resolution computed tomography showed a cystic lesion with air-fluid level measuring 5.7×4.5×5 cm in the subpleural region of the right lower lobe of the lung. Cardiac magnetic resonance imaging confirmed an intramyocardial hydatid cyst at the apex of the left ventricle.