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March 2008 Br J Cardiol 2008;15:110

Surgery for palpitations?

Peadar F McKeown, Ian B A Menown, Paul F Rice

Abstract

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

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