Progress of untreated massive cardiac echinococcosis - Echocardiographic follow-up

A 56-year-old man was admitted with chest pain and dyspnea. Echocardiographic evaluation revealed a giant cystic cardiac mass with multiple loculations at interventricular septum extended to inferoposterior region protruding inside the cavity. The patient refused surgical therapy. His complaints persisted without significant changes after 5 months. Second echocardiographic evaluation revealed conjugation of previous multiple cyst to gigantic intramyocardial cyst and minimal pericardial effusion. We intend to illustrate herein an unusual echocardiographic appearance and progress of an untreated massive "cardiac echinococcosis." If cardiac hydatid cyst is left untreated it may transform to large cavity with a high risk of rupture.