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March 2025 Br J Cardiol 2025;32(1) doi:10.5837/bjc.2025.015 Online First

Pericardial cyst: an unexpected diagnosis in a patient presenting with breathlessness

Henry HL Wu, Omar Elboraey, Joseph Zacharias, Danielle Bury, Chee Kheng Liew, Irfan Ahmed

Abstract

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

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