Myocardial perfusion SPECT defects resulting from cystic echinococcosis in the pericardium

A 58-year-old man was admitted for myocardial perfusion SPECT. As a result of complaints of uncharacteristic chest pain and functional dyspnea, exercise testing was performed one month earlier. He did not get any symptoms during the test, but the ECG showed exercise-induced significant ST depression in leads V1-V3. That is why he was admitted for myocardial perfusion SPECT. It showed an irreversible defect in the anterolateral pericardial part of the left ventricle. A second stress myocardial perfusion SPECT with attenuation correction was performed and correction for attenuation removed only some of the defect. A CT scan of the thorax showed a multiseptae cyst in the pericardial wall in relation to the left ventricle and a partially calcified cyst in the liver. MRI of the heart confirmed that it was pericardial cystic echinococcosis. Human cystic echinococcosis is a rare condition. In approximately 1% of the cases, there are cysts in the mediastinum or the heart. Copyright © 2006 by Lippincott Williams & Wilkins.