Pericardial cyst in an elderly patient with atrial fibrillation: a clinical case

Abstract

Pericardial cysts are rare mediastinal lesions that are usually asymptomatic and often discovered incidentally on chest radiographs. Pericardial cysts can be congenital or acquired (due to inflammation, infection, trauma, parasitic infection, etc.). In the article, we presented a clinical case of a 74-year-old man with coronary heart disease, paroxysmal atrial fibrillation associated with obesity, who developed right ventricular failure. The pericardial cyst was not visualized on a plain chest X-ray. The diagnosis was made using computed tomography and echocardiography. The dimensions of the pericardial cyst according to CT data are 70×52×80 mm, with contrast enhancement without accumulation of contrast agent, the formation compressed the right ventricle of the heart. Complex conservative treatment of coronary heart disease in combination with rhythm control was effective. To resolve the issue of surgical decision, the patient was transferred to cardiac surgery. The article presents an analysis of the main causes of this pathological condition, research data, and treatment tactics. It is necessary to know the clinic of pericardial cysts and take them into account in differential diagnosis.