Blood-filled cysts of heart.

A45-year-old man presented with breathing difficulty of one month duration. He was euglycemic and normotensive, and had no history of myocardial infarction or angina. On clinical examination his jugular venous pressure was elevated and S 3 gallop was present. His ECG showed pathological q waves in inferior leads and poor progression of R waves in anterior chest leads. Chest X-ray revealed cardiomegaly with cardiothoracic ratio of 17/28. His abdominal ultrasonography was normal. He was advised echocardiography to assess the left ventricular function. Echocardiogram revealed three cystic structures of various sizes in the left ventricle ( Figs 1-3). These cysts were seen in apical four-chamber, long axis and short axis views. These cysts were well circumscribed, had a thin wall and echolucent core. Based on these characteristic findings, we made a diagnosis of blood-filled cyst of heart, which is a rare condition. Blood-filled cyst of the heart was first described in 1844 by Elsasser. Houser et al. first reported the use of echocardiography for detection of intracardiac blood-filled cyst in 1983. Cyst wall consists of endothelial cells and a thin layer of fibrous tissue that contains non-organised blood or serosanguinous f luid. The echocardiographic appearance of these cysts (well-circumscribed mass with a thin wall and echolucent core) is characteristic and has since been confirmed by several echocardiographicpathologic correlations. Intracardiac blood-filled cysts are typically asymptomatic, usually congenital in origin, seen predominantly in infants. These cysts have been described on the mitral valve, papillary muscles and aortic valve as Cardi vascular Imag s