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Pleuropericarditis complicated by a pericardial cyst.

ABSTRACT: We report the case of a 36-year-old woman with a recent upper respiratory illness who presented with chest pressure, lasting for five days, which improved with leaning forward. Physical examination and laboratory studies were unremarkable. Chest computed tomography scan revealed a 6.9 cm × 4 cm × 2.5 cm pericardial cyst. The patient was diagnosed with pleuropericarditis complicated by a pericardial cyst. Pericardial cysts are rare mediastinal lesions that are often congenital, but may be inflammatory. If symptomatic, surgical resection or percutaneous aspiration may be considered. In our patient, treatment with ibuprofen and colchicine resulted in a decrease in cyst size, suggesting an inflammatory component. We describe an uncommon case of reduction of a pericardial cyst shortly after treatment of pericarditis due to a probable viral infection. Non-operative management of pericardial cysts may be appropriate in these select cases. .

SUBMITTER: Imran TF

PROVIDER: S-EPMC6281869 | biostudies-other | 2015 Nov

REPOSITORIES: biostudies-other

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Pleuropericarditis complicated by a pericardial cyst.

Imran Tasnim F TF Shah Rashesh R Qavi Ahmed H AH Waller Alfonso A Kim Bernard B

Journal of cardiology cases 20150727 5

We report the case of a 36-year-old woman with a recent upper respiratory illness who presented with chest pressure, lasting for five days, which improved with leaning forward. Physical examination and laboratory studies were unremarkable. Chest computed tomography scan revealed a 6.9 cm × 4 cm × 2.5 cm pericardial cyst. The patient was diagnosed with pleuropericarditis complicated by a pericardial cyst. Pericardial cysts are rare mediastinal lesions that are often congenital, but may be inflamm ...[more]

PMID: 30546583

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Project description:IntroductionPericardial cysts are considered as a rare congenital abnormality, mostly found incidentally. The estimated incidence of pericardial cyst is 1:100,000 and represent approximately 6% of all mediastinal masses. Patients can present with symptoms similar to acute chest pain or right-sided heart failure or can be asymptomatic.PresentationA 46-year-old female who is known to have hypertension and hypothyroidism presented to the breast clinic with left breast mass that was proved by core needle biopsy as proliferative breast lesion. During the preoperative assessment, the patient reported progressive shortness of breath and cough over the last two years and bilateral lower limb edema. Her preoperative chest X-ray showed a well-defined oval like opacification at the right cardiophrenic angle that was proved by chest computed tomography imaging as a cystic mass od most likely a pericardial origin. A huge pericardial cyst originating from the right diaphragmatic surface was excised through a mini-sternotomy incision with smooth postoperative recovery. The patient-reported significant improvement in her symptoms and her lifestyle during her follow up.DiscussionPericardial cysts represent 6%-7% of all mediastinal masses with an estimated incidence of 1:100,000. About 70% of pericardial cysts originate at the right cardiophrenic angle and less frequently at the left cardiophrenic angle, they are usually suspected when the chest x-ray shows an enlarged contour of the right heart border. Mediastinal cysts have many differential diagnoses and the preoperative decision might be challenging in many cases. Pericardial cysts appear as oval, thin-walled homogeneous masses on cardiac computed tomography. The choice between surgical intervention and conservative follow up is related mainly to the size and symptoms that are induced by the cyst.ConclusionAs pericardial cysts are rarely diagnosed pathology, a high index of suspicion is essential for diagnosis. Surgical resection is indicated when they are huge, enlarging in size or symptomatic. Morbidity and mortality risks following pericardial cyst excision are very low.

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Pleuropericarditis complicated by a pericardial cyst.

Publications

Pleuropericarditis complicated by a pericardial cyst.

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