A Case of an Inflamed Pericardial Cyst As the Cause of Acute Onset Chest Pain in a Young Patient and Review of the Literature

Abstract

Among the extensive variety of disorders that can cause chest pain are the complicated pericardial cysts, pathological entities that otherwise are asymptomatic. Here, we describe a 34-year-old male patient with a symptomatic pericardial cyst presenting at the emergency department with acute chest pain that woke him up about six hours prior to presentation. The work up for his acute chest pain revealed a well-defined, fluid-filled, rounded mass next to the pericardium on the right cardiophrenic angle and increased acute phase reactants. The cyst was surgically removed and the biopsy showed signs of intense inflammatory infiltration with negative culture of the fluid. The patient received intravenous antibiotics for two weeks with complete resolution of the symptoms and remained asymptomatic for about two months after surgical excision. Among other symptoms that may be induced from the presence of a pericardial cyst, the acute onset of chest pain, in this otherwise benign condition, probably indicates the existence of a complication such as rupture, inflammation, or hemorrhage. Careful exclusion of other etiologies of chest pain is mandatory as the surgical excision of a complicated pericardial cyst remains the only therapeutic option.

Surgical Management of Pericardial Cysts: A Single-Center Retrospective Study

“…Depending on the cyst size and anatomic location, the clinical presentation relies heavily on the pressure generated by the cyst on adjacent structures. PCs can present with chest pain, dyspnea, cough, syncope, and arrhythmia [9][10][11]. They are usually detected between the age of 30 to 50 years with no gender preference [12].…”