title: Usefulness of bubble study in echocardiographic diagnosis of contained rupture of hydatid cyst in the right ventricular outflow tract.
abstract: We describe an adult female presenting with dyspnea in whom both transthoracic and transesophageal echocardiography detected a mobile sac-like structure in the right ventricular outflow tract (RVOT) containing a heterogenous echogenic mass. This sac-like structure markedly changed its shape and size during the cardiac cycle. These findings and the fact that the patient lived in a rural area raised the possibility that this was a hydatid cyst. A bubble study using normal saline was useful in detecting a contained rupture of the cyst. Bubble echoes were noted within the sac-like structure but did not penetrate the inner wall of the cyst which contained echogenic material, indicating that the rupture was confined only to the outer layers. At surgery, a 0.5 cm communication was noted between the cyst and the RVOT and pathology confirmed the diagnosis of hydatid cyst.
authors.affiliation: Department of Cardiology, St. Luke's University Health Network, Bethlehem, Pennsylvania.
authors.forename: Amitoj
authors.initials: A
authors.lastname: Singh
authors.affiliation: Santokba Durlabhji Memorial Hospital, Jaipur, Rajasthan, India.
authors.forename: Ravindra
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Jaipur Heart Institute, Jaipur, Rajasthan, India.
authors.forename: Ashok
authors.initials: A
authors.lastname: Garg
authors.affiliation: Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama. nanda@uab.edu.
authors.forename: Navin C
authors.initials: NC
authors.lastname: Nanda
authors.affiliation: Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Elsayed
authors.affiliation: Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Taher
authors.affiliation: Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Serkan
authors.initials: S
authors.lastname: Bulur
mesh_terms: D003937:Diagnosis, Differential; D004443:Echinococcosis / Q000000981:diagnostic imaging*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008875:Middle Aged; D012422:Rupture, Spontaneous; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging*
keywords: bubble study; cardiac hydatid cyst; echinococcus; echo contrast study; echocardiography; hydatid cyst rupture; transthoracic echocardiography