title: [A very uncommon reason for chest pain].
abstract: A 25-year old female immigrant from Kosovo living in Switzerland for three years complained of intermittent atypical chest pain and shortness of breath for three months. The patient was febrile (38.4 °C) and had a regular tachycardia of 120/min and a blood pressure of 105/65 mmHg. The ECG showed deep symmetric negative T-waves on the leads V1 - V6. The conventional chest X-ray revealed a small bulge of the left cardiac outline. Leucocytes and differential count were normal but the C-reactive protein was markedly elevated (118mg/L). Computed tomography of the chest revealed several pleural and paramediastinal cystic masses on the left side. One of these cystic lesions covered a small defect of the aortic wall appearing as a pseudoaneurysm at the beginning of the descending aorta. Echocardiography showed pericardial cysts on the left ventricle and a small pericardial effusion. Serological tests for Echinococcus granulosus were strongly positive. Thus, the patient was diagnosed with cystic echinococcosis with pericardial, pleural and mediastinal involvement with a pseudoaneurysm of the descending aorta.
authors.affiliation: Kantonsspital Schaffhausen, Medizinische Klinik.
authors.forename: T
authors.initials: T
authors.lastname: Eckle
authors.forename: J
authors.initials: J
authors.lastname: Peter
authors.forename: S
authors.initials: S
authors.lastname: Rüttimann
mesh_terms: D000328:Adult; D000415:Albania / Q000208:ethnology; D002637:Chest Pain / Q000000981:diagnostic imaging* / Q000209:etiology*; D003937:Diagnosis, Differential; D004443:Echinococcosis / Q000000981:diagnostic imaging*; D004562:Electrocardiography; D054242:Emigrants and Immigrants; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007091:Image Processing, Computer-Assisted; D008476:Mediastinal Cyst / Q000000981:diagnostic imaging; D010496:Pericardium / Q000000981:diagnostic imaging*; D013557:Switzerland; D013610:Tachycardia / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed