• Sweta Giri, Shankar LeVine, and Melanie R Watts.
• Department of Emergency Medicine, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
• J Emerg Med. 2020 Jun 1; 58 (6): e243-e246.

BackgroundHydatid cysts are caused by Echinococcus granulosus infection, and hydatidosis is recognized as a re-emerging zoonotic disease globally. While the liver is the most commonly affected organ, other organs can also be affected, including the heart. Because of the low sensitivity and specificity of serologic diagnostic tests, ultrasound and echocardiography are increasingly used to make the diagnosis of cardiac hydatid cyst.Case ReportWe report the case of a cardiac hydatid cyst, detected by point-of-care ultrasound (POCUS), in a 79-year-old woman who presented with shortness of breath and was in ventricular tachycardia. The diagnosis was further confirmed with a computed tomography scan. Although cases of alveolar and liver hydatid cysts are seen, this is the first case of a cardiac hydatid cyst in Bhutan. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case illustrates the importance of POCUS in reaching a diagnosis, particularly in resource-poor areas where other sophisticated diagnostic tools are not easily available. A cardiac hydatid cyst must be in the differential for structural causes of dysrhythmias. This is especially so because treatment of unstable dysrhythmias in the acute setting of an emergency department has to be modified from the usual algorithm in the presence of a cardiac hydatid cyst, due to the potentially fatal risk of cyst rupture and anaphylaxis.Copyright © 2020 Elsevier Inc. All rights reserved.

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