In recent decades, cardiac magnetic resonance imaging (CMR) has been established as a valuable tool in the diagnosis of patients with or at risk of heart failure. With its ability to characterize tissue changes in the myocardium, CMR can provide detailed and clinically useful information about the type and severity of cardiac damage. The method is not only important for differentiation of ischemic from non-ischemic cardiomyopathy, but also contributes to the correct diagnosis of non-ischemic cardiomyopathy subtypes. It is also widely accepted as a reference standard for the quantification of myocardial mass, volumes and ejection fraction. The purpose of this article is to review the role of CMR in the diagnosis and treatment of non-ischemic cardiomyopathies.
We present two case reports of cardiac echinococcosis. Case 1 was a 33-year-old woman with hepatic and cardiac echinococcosis. The parasitic cyst was located intramyocardially in the free wall of the left ventricle leading to cranial dislocation of the left circumflex coronary artery (LCx). The patient was successfully operated. Case 2 was a 28-year-old woman with hepatic and cardiac echinococcosis. The parasitic cyst was located in the left ventricular myocardium in the area of the apex and manifested clinically as paroxysms of ventricular tachycardia. The ultrasound study showed a 3.2×2.8 cm cyst dislocating the papillary muscles and causing moderate mitral regurgitation.
Bulgaria ranks first in the European Union in terms of the number of echinococcosis patients. Although cardiac involvement is uncommon, occurring in only 0.5%–2% of cases, it can cause a wide range of clinical symptoms. Multimodal imaging is a key step in the management of patients with cardiac involvement.
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