Tag Archives: pericardial cyst

Case presentation A 49-year-old man presented with a four-day history of progressive breathlessness and chest tightness. Breathlessness was exacerbated by deep inspiration and mild exertion. The patient reported reduced exercise tolerance compared to his baseline, together with lethargy, loss of appetite, intermittent fever, and night sweats during the preceding two weeks. There was no significant past medical history or recent surgery. However, he reported an extensive travel history to the Himalayas. Physical examination revealed a sinus tachycardia without further notable findings. Investigations showed a neutrophilic leucocytosis (white b

Physical examination, electrocardiography, chest x-ray and a Bruce exercise stress test were unremarkable. A 24-hour tape revealed intermittent ventricular ectopics that coincided with his symptoms of palpitations. On non-standard views, echocardiography showed a large echolucent mass that was compressing the right ventricle (figure 1A). Left ventricular ejection fraction was preserved. Computed tomography (CT) of chest and abdomen demonstrated a massive lobulated cyst in the anterior mediastinum, arising from the pericardium, measuring 15.3 cm x 8.2 cm (figure 1B). CT-guided aspiration (figure 1C) obtained 600 ml of straw-coloured fluid (tra