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A 65-year-old female was admitted with progressive exertional dyspnoea and chest pain. Chest radiography revealed an enlarged cardiac silhouette suspicious for a large pericardial effusion (Fig. 1a). Transthoracic echocardiogram was normal, apart from a large echo-lucent space strictly limited to the anterolateral border of the left ventricle (Fig. 1b). Computed tomography scan showed a large cystic mass at the left heart border (17 × 7 cm, see Fig. 1c). Patient underwent video-assisted thoracic surgery in which the entire cyst was removed. During surgery the diagnosis pericardial cyst was confirmed. Chest radiography afterwards showed a normal heart contour (Fig. 1d).
Pericardial cysts are mostly diagnosed in women around 50 years [1]. Ninety percent of the patients are asymptomatic. If symptoms occur, chest pain is most common, followed by dyspnoea and palpitations [1].
Pericardial cysts are located in the right heart border in 80%, less frequently in the left heart border (15%) and, rarely, in the anterior mediastinum [1].
References
Alkharabsheh S, Gentry JL III., Khayata M, et al. Clinical features, natural history, and management of pericardial cysts. Am J Cardiol. 2019;123(1):159–63.
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T.H. Pinxterhuis, A.P. van der Weerdt and C.A. da Fonseca declare that they have no competing interests.
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Pinxterhuis, T.H., van der Weerdt, A.P. & da Fonseca, C.A. Pericardial cyst on the left heart border. Neth Heart J 27, 583–584 (2019). https://doi.org/10.1007/s12471-019-1301-y
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DOI: https://doi.org/10.1007/s12471-019-1301-y