Inflammation and Rupture of a Congenital Pericardial Cyst Manifesting Itself as an Acute Chest Pain Syndrome

Abstract

We present the case of a 63-year-old woman with a remote history of supraventricular tachycardia and hyperlipidemia, who presented with recurrent episodes of acute-onset chest pain. An electrocardiogram showed no evidence of acute coronary syndrome. A chest radiograph revealed a prominent right-sided heart border. A suspected congenital pericardial cyst was identified on a computed tomographic chest scan, and stranding was noted around the cyst. The patient was treated with nonsteroidal anti-inflammatory drugs, and the pain initially abated. Another flare-up was treated similarly. Cardiac magnetic resonance imaging was then performed after symptoms had resolved, and no evidence of the cyst was seen. The suspected cause of the patient's chest pain was acute inflammation of a congenital pericardial cyst with subsequent rupture and resolution of symptoms.

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

“…In some previous published cases, pain was attributed to the size of the cyst itself and it had chronic character [ 11 , 16 ]. In other cases, with acute onset of chest pain or exacerbation of chronic chest pain, the cause was hemorrhage into the cyst [ 19 ], inflammation of a cyst [ 17 ], or the rupture of an inflamed cyst [ 18 , 20 ]. In all the cases of inflamed cysts, no specific cause of this inflammation process has been ascertained.…”

A rare complication of a rare disease: Pericarditis due to ruptured pericardial cyst

“…Acquired pericardial cysts can occur due to infections, with the leading cause being a rare complication of Echinococcosis hydatid cysts 2. Other acquired causes include malignant metastasis, post-traumatic, pericarditis, cardiac surgery, and rheumatic heart disease 10. There is limited literature showing that ruptured pericardial cyst may present with acute chest pain syndrome 10.…”

“…Other acquired causes include malignant metastasis, post-traumatic, pericarditis, cardiac surgery, and rheumatic heart disease 10. There is limited literature showing that ruptured pericardial cyst may present with acute chest pain syndrome 10. To the best of our knowledge, pericarditis complicating a ruptured pericardial cyst has not been previously reported in the literature.…”