1
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Aydin Y, Ozmen S, Ulas AB, Eroglu A. An important finding for differential diagnosis in thymic cyst mimicking pericardial cyst: punctate calcification. Indian J Thorac Cardiovasc Surg 2024; 40:502-503. [PMID: 38919173 PMCID: PMC11194224 DOI: 10.1007/s12055-024-01710-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/04/2024] [Accepted: 02/18/2024] [Indexed: 06/27/2024] Open
Abstract
Mediastinal cysts are usually congenital but present in adulthood. A pericardial cyst is usually localized in the right cardiophrenic region. Thymic cysts are less common and are located in the cervical region or anterior mediastinal region. While thoracoscopic excision or aspiration can be applied in pericardial cysts, excision is recommended in thymic cysts. We present a case of a thymic cyst located in the localization of the pericardial cyst and radiologically containing wall punctate calcification.
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Affiliation(s)
- Yener Aydin
- Medical Faculty, Department of Thoracic Surgery, Ataturk University, 25240 Erzurum, Turkey
| | - Sevilay Ozmen
- Medical Faculty, Department of Pathology, Ataturk University, Erzurum, Turkey
| | - Ali Bilal Ulas
- Medical Faculty, Department of Thoracic Surgery, Ataturk University, 25240 Erzurum, Turkey
| | - Atilla Eroglu
- Medical Faculty, Department of Thoracic Surgery, Ataturk University, 25240 Erzurum, Turkey
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2
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Schiavone WA, Majdalany DS. Chest Radiography Pearls in Select Adult Congenital Heart Disease. J Pers Med 2024; 14:397. [PMID: 38673024 PMCID: PMC11051131 DOI: 10.3390/jpm14040397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 04/02/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
Congenital heart disease in adult patients (ACHD) includes individuals with native anatomic deformities and those who have benefited from corrective, ameliorative, or interventional heart and vascular interventions. Congenital heart disease is the most common birth defect, although with interventions most survive into adulthood. Newborns and children with complex congenital heart diseases that feature cyanosis fail to thrive, and once this is identified, heart failure can promptly undergo diagnostic evaluations and treatment. However, patients with simple congenital heart disease and subtle clinical signs and symptoms may escape diagnosis until adulthood or experience changes in their cardiac hemodynamics and physiology in settings such as pregnancy or newly diagnosed arrhythmias. The chest X-ray (CXR) is the most common X-ray among all radiological procedures. Individual features or a constellation of features on a CXR are often present in patients who have congenital heart disease. The ability to recognize these CXR features is a valuable skill for making the diagnosis of ACHD and for following these patients as they age, and can complement echocardiographic findings. When used well to diagnose ACHD, the CXR will be the sharpest arrow in the quiver.
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Affiliation(s)
| | - David S. Majdalany
- Department of Cardiovascular Diseases, Mayo Clinic, Phoenix, AZ 85054, USA
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3
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Zhang WM, Maimaitiaili A, Aizezi R, Abulimiti K, Yan F, Huo Q. Surgical Management of Pericardial Cysts: A Single-Center Retrospective Study. Cureus 2023; 15:e49298. [PMID: 38957189 PMCID: PMC11218600 DOI: 10.7759/cureus.49298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 07/04/2024] Open
Abstract
Introduction Pericardial cysts (PCs) are infrequent, non-malignant, and congenital abnormalities. The identification and treatment of PCs remain a significant challenge, with limited research on surgical management. Methods We performed a retrospective study of patients with PCs who underwent surgical intervention at the First Affiliated Hospital of Xinjiang Medical University from February 2002 to December 2022. Results A total of 55 patients underwent surgery due to PCs during the study period. Thirty-one were females and 24 were males. The average age of the patients was 44.7 ± 12.9 (six to 63 years old). PCs were located in the right hemithorax in 50 (90.9%) patients and left hemithorax in five (9.1%) patients. Approach methods were video-assisted thoracoscopic surgery (VATS) in 43 (78.2%) cases; thoracotomy in 11 (20%) cases, and median sternotomy in one (1.8%) cases. The average postoperative hospitalization period was 5.6 days (two to 14 days). Three patients developed postoperative complications (two pleural effusion, one pneumonia), whereas no mortality was observed in any patient due to the operation. Forty-one patients (74.5%) were followed up for three months to eight years postoperatively, during which no recurrent cysts were detected. Conclusion In this single-center retrospective study, we demonstrated that pericardial cyst cure is an appropriate operation according to cyst characteristics. VATS has been shown to be highly effective and safe in patients with PCs, offering the advantage of reducing postoperative morbidity efficiently.
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Affiliation(s)
- Wei-Min Zhang
- Department of Cardiac Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, CHN
| | - Abdunabi Maimaitiaili
- Department of Cardiac Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, CHN
| | - Rehemutulajiang Aizezi
- Department of Cardiac Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, CHN
| | - Kadeyanmu Abulimiti
- Department of Cardiac Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, CHN
| | - Fei Yan
- Department of Cardiac Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, CHN
| | - Qiang Huo
- Department of Cardiac Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, CHN
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4
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Chalhoub G, Kamel A, Levsky J, Schenone A, Garcia MJ. A Large Cyst in an Unlikely Location: The Interventricular Septum. CASE (PHILADELPHIA, PA.) 2023; 7:401-404. [PMID: 37970483 PMCID: PMC10635888 DOI: 10.1016/j.case.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
•A large cardiac cyst was discovered in an extremely rare location: the IVS. •Pre- and postcontrast imaging is essential in the evaluation of a cystic mass. •When identifying a cardiac cyst, malignancy and infection must be considered. •The benefit of excising a cardiac cyst is unclear in an asymptomatic older patient.
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Affiliation(s)
- George Chalhoub
- Department of Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Andrew Kamel
- Department of Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Jeffrey Levsky
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Aldo Schenone
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Mario J. Garcia
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
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5
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Nomura K, Moronuki T, Takeuchi S, Maeda T, Iida S, Yamamoto K. Practical approach of transthoracic echocardiography for pericardial cyst: a case report. J Echocardiogr 2023; 21:134-135. [PMID: 35426039 DOI: 10.1007/s12574-022-00574-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/17/2022] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Kazuhiro Nomura
- Department of Laboratory Medicine, Saitama Medical University Hospital, 38 Morohongo, Moroyama-Machi, Iruma-gun, Saitama, 350‑0495, Japan.
| | - Takahisa Moronuki
- Department of Laboratory Medicine, Saitama Medical University Hospital, 38 Morohongo, Moroyama-Machi, Iruma-gun, Saitama, 350‑0495, Japan
| | - Shinichi Takeuchi
- Department of Laboratory Medicine, Saitama Medical University Hospital, 38 Morohongo, Moroyama-Machi, Iruma-gun, Saitama, 350‑0495, Japan
| | - Takuya Maeda
- Department of Laboratory Medicine, Saitama Medical University Hospital, 38 Morohongo, Moroyama-Machi, Iruma-gun, Saitama, 350‑0495, Japan
| | - Shinichiro Iida
- Department of Cardiovascular Medicine, Saitama Medical University Hospital, 38 Morohongo, Moroyama-Machi, Iruma-gun, Saitama, 350‑0495, Japan
| | - Keiji Yamamoto
- Department of Cardiovascular Medicine, Saitama Medical University Hospital, 38 Morohongo, Moroyama-Machi, Iruma-gun, Saitama, 350‑0495, Japan
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6
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Kurmann R, El-Am E, Ahmad A, Abbasi MA, Mazur P, Akiki E, Anand V, Herrmann J, Casanegra AI, Young P, Crestanello J, Bois MC, Maleszewski JJ, Klarich K. Cardiac Masses Discovered by Echocardiogram; What to Do Next? STRUCTURAL HEART : THE JOURNAL OF THE HEART TEAM 2023; 7:100154. [PMID: 37520139 PMCID: PMC10382990 DOI: 10.1016/j.shj.2022.100154] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/06/2022] [Accepted: 12/21/2022] [Indexed: 02/12/2023]
Abstract
Cardiac tumors are rare conditions, typically diagnosed on autopsy, but with the advancement of imaging techniques they are now encountered more frequently in clinical practice. Echocardiography is often the initial method of investigation for cardiac masses and provides a quick and valuable springboard for their characterization. While some cardiac masses can be readily identified by echocardiography alone, several require incorporation of multiple data points to reach diagnostic certainty. Herein, we will provide an overview of the main clinical, diagnostic, and therapeutic characteristics of cardiac masses within the framework of their location.
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Affiliation(s)
- Reto Kurmann
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Edward El-Am
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Ali Ahmad
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Piotr Mazur
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Elias Akiki
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Vidhu Anand
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Joerg Herrmann
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Ana I. Casanegra
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Phillip Young
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Juan Crestanello
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Melanie C. Bois
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Laboratory Medicine & Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Joseph J. Maleszewski
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Laboratory Medicine & Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Kyle Klarich
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
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7
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Wang X, Zhang W, Wang M, Jiao R. Prenatal ultrasound diagnosis of fetal giant pericardial cyst: A case report. Medicine (Baltimore) 2023; 102:e34119. [PMID: 37352036 PMCID: PMC10289504 DOI: 10.1097/md.0000000000034119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/02/2023] [Accepted: 06/07/2023] [Indexed: 06/25/2023] Open
Abstract
RATIONALE We describe 1 case of fetal giant pericardial cyst was diagnosed by fetal echocardiography in the second trimester, and the changes of the cyst were recorded by follow-up observation in the late trimester and after birth. We then review and discuss the knowledge about its diagnosis and treatment. PATIENT CONCERNS A 34-year-old pregnant woman was referred to our hospital because of a diagnosis of a fetal pericardial effusion at 22 5/7 weeks at another hospital. DIAGNOSIS Fetal echocardiography revealed an irregular anechoic area in the right side of the fetal right atrium and right ventricle that was closely related to but not communicated with the pericardiumis and suggested fetal pericardial cyst. Fetal cardiothoracic magnetic resonance imaging showed cystic FIESTA signal in the right lung region, with clear boundary, and a seemingly line-like low signal shadow within. INTERVENTIONS Since fetal pericardial cysts keep decreasing in size during maternal pregnancy, follow-up observation measures are taken. OUTCOMES Fetal pericardial cysts disappear on their own 4 months after delivery. LESSONS Asymptomatic pericardial cysts in the fetal period can be followed up and observed, and intervention is performed only when the cyst rapidly enlarges or ruptures and becomes infected in the fetal or neonatal period. Echocardiography can be used as a first-line detection method for their initial detection and follow-up.
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Affiliation(s)
- Xiaoqing Wang
- Hebei Medical University, Shijiazhuang, China
- Department of Ultrasound, Hebei General Hospital, Shijiazhuang, China
| | - Weixia Zhang
- Department of Ultrasound, Hebei General Hospital, Shijiazhuang, China
| | - Mijie Wang
- Department of Ultrasound, Hebei General Hospital, Shijiazhuang, China
| | - Ronghong Jiao
- Department of Ultrasound, Hebei General Hospital, Shijiazhuang, China
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8
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Shirzadi R, Roshanzamir Z, Pak N, Rajabi R, Mohammadi F. An unusual site of a pericardial cyst in a child: A case report. Radiol Case Rep 2023; 18:1498-1501. [PMID: 36816338 PMCID: PMC9932291 DOI: 10.1016/j.radcr.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 02/05/2023] Open
Abstract
Pericardial cysts are rare congenital anomalies, often clinically silent and incidentally found on imaging. However, patients with pericardial cysts may present with chest pain, tachypnea, and, rarely, symptoms secondary to cardiac tamponade. Echocardiography (transthoracic or transesophageal) and chest computed tomography (CT) scan with contrast are diagnostic modalities of choice in patients with pericardial cysts. Conservative management is justified in asymptomatic patients, while a surgical approach is recommended in symptomatic patients. Here, we describe the case of a 12-year-old boy who underwent imaging during the coronavirus disease 2019 (COVID-19) pandemic and was incidentally found to have a pericardial cyst.
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Affiliation(s)
- Rohola Shirzadi
- Pediatric Respiratory and Sleep Medicine Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Roshanzamir
- Pediatric Respiratory and Sleep Medicine Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran,Pediatric Respiratory Center, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Pak
- Department of Radiology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Fatemeh Mohammadi
- Tehran University of Medical Sciences, Tehran, Iran,Children's Medical Center, No 63, Gharib Ave, Keshavarz Blvd., Tehran, 14194, Iran,Corresponding author.
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9
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Zhao K, Zhang L, Wang L, Zeng J, Zhang Y, Xie X. Benign incidental cardiac findings in chest and cardiac CT imaging. Br J Radiol 2023; 96:20211302. [PMID: 35969186 PMCID: PMC9975525 DOI: 10.1259/bjr.20211302] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 07/25/2022] [Accepted: 08/06/2022] [Indexed: 02/01/2023] Open
Abstract
With the continuous expansion of the disease scope of chest CT and cardiac CT, the number of these CT examinations has increased rapidly. In addition to their common indications, many incidental cardiac findings can be observed when carefully evaluating the coronary arteries, valves, pericardium, ventricles, and large vessels. These findings may have clinical significance or risk of complications, but they are sometimes overlooked or may not be described in the final reports. Although most of the incidental findings are benign, timely detection and treatment can improve the management of chronic diseases or reduce the possibility of severe complications. In this review, we summarized the imaging findings, incidence rate, and clinical relevance of some benign cardiac findings such as coronary artery calcification, aortic and mitral valve calcification, aortic calcification, cardiac thrombus, myocardial bridge, aortic dilation, cardiac myxoma, pericardial cyst, and coronary artery fistula. Reporting incidental cardiac findings will help reduce the risk of severe complications or disease deterioration and contribute to the recovery of patients.
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Affiliation(s)
- Keke Zhao
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Haining Rd.100, Shanghai, China
| | - Lu Zhang
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Haining Rd.100, Shanghai, China
| | - Lingyun Wang
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Haining Rd.100, Shanghai, China
| | - Jinghui Zeng
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Haining Rd.100, Shanghai, China
| | - Yaping Zhang
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Haining Rd.100, Shanghai, China
| | - Xueqian Xie
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Haining Rd.100, Shanghai, China
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10
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Fukudome Y, Hieda M, Masui S, Yokoyama T, Futami S, Moriyama S, Irie K, Fukata M, Ushijima T, Shiose A, Akashi K. Case Report: Bronchogenic Cyst in the Right Atrium of a Young Woman. Front Cardiovasc Med 2022; 9:915876. [PMID: 35711360 PMCID: PMC9197382 DOI: 10.3389/fcvm.2022.915876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/02/2022] [Indexed: 12/03/2022] Open
Abstract
A 31-year-old woman was referred to our hospital for evaluation of a cardiac mass in the right atrium. Cardiac magnetic resonance imaging indicated a cystic mass filled with fluid accumulation in the right atrium. The mass was identified as a cardiac cyst and was surgically removed. Pathological examination revealed an extremely rare bronchogenic cyst. Bronchogenic cysts are benign congenital abnormalities of primitive foregut origins that form in the mediastinum during embryonic development. There is unusual clinical dilemmas surrounding the treatment plan for cardiac surgery or biopsy of cardiac masses, especially in patients with rare cardiac cysts. The anatomical location of the cyst can be related to various clinical symptoms and complications. In cases of indeterminate cardiac cysts, direct cyst removal without prior biopsy is of utmost importance.
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Affiliation(s)
- Yuya Fukudome
- Heart Center, Kyushu University Hospital, Fukuoka, Japan
| | - Michinari Hieda
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
- *Correspondence: Michinari Hieda,
| | - Shiho Masui
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Taku Yokoyama
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Shutaro Futami
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Shohei Moriyama
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Kei Irie
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Mitsuhiro Fukata
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Tomoki Ushijima
- Department of Cardiovascular Surgery, Kyushu University Hospital, Fukuoka, Japan
| | - Akira Shiose
- Department of Cardiovascular Surgery, Kyushu University Hospital, Fukuoka, Japan
| | - Koichi Akashi
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
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11
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Lazaros G, Lazarou E, Tsioufis P, Soulaidopoulos S, Iliakis P, Vlachopoulos C, Tsioufis C. Chronic pericardial effusion: current concepts and emerging trends. Expert Rev Cardiovasc Ther 2022; 20:363-376. [PMID: 35524164 DOI: 10.1080/14779072.2022.2075346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Pericardial effusion (PEF) is a common and challenging pericardial syndrome with a variety of clinical manifestations ranging from asymptomatic, incidentally uncovered small PEFs, to life-threatening cardiac tamponade. AREAS COVERED : This review focuses on the pathophysiology, epidemiology, etiology, classification, clinical findings, diagnostic work-up, management and outcome of PEFs. Particular emphasis has been given on the most recent evidence concerning the contribution of imaging for the detection, differential diagnosis and evaluation of the hemodynamic impact of PEFs on the diastolic filling of the heart. Moreover, simplified algorithms for PEF triage and management have been included. EXPERT OPINION The management of patients with PEFs is mainly based on four parameters namely hemodynamic impact on diastolic function, elevation of inflammatory markers, presence of a specific underlying condition known to be associated with PEF and finally size and duration of the effusion. Novel data have contributed to change our view towards large, asymptomatic, "idiopathic" PEFs and dictated a rather conservative approach in most cases. It is also stressed that there is a compelling need for additional research, which is essential for tailored treatments aiming at the improvement of quality of life and containment of health care costs.
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Affiliation(s)
- George Lazaros
- First Department of Cardiology, "Hippokration" Hospital, University of Athens Medical School, Athens, Greece
| | - Emilia Lazarou
- First Department of Cardiology, "Hippokration" Hospital, University of Athens Medical School, Athens, Greece
| | - Panagiotis Tsioufis
- First Department of Cardiology, "Hippokration" Hospital, University of Athens Medical School, Athens, Greece
| | - Stergios Soulaidopoulos
- First Department of Cardiology, "Hippokration" Hospital, University of Athens Medical School, Athens, Greece
| | - Panagιotis Iliakis
- First Department of Cardiology, "Hippokration" Hospital, University of Athens Medical School, Athens, Greece
| | - Charalambos Vlachopoulos
- First Department of Cardiology, "Hippokration" Hospital, University of Athens Medical School, Athens, Greece
| | - Costas Tsioufis
- First Department of Cardiology, "Hippokration" Hospital, University of Athens Medical School, Athens, Greece
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12
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Armstrong SM, Thavendiranathan P, Butany J. The pericardium and its diseases. Cardiovasc Pathol 2022. [DOI: 10.1016/b978-0-12-822224-9.00021-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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13
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Nocco S, Parato V, Alunni G, Becherini F, Conti S, Cucchini U, Di Giannuario G, Di Nora C, Fabiani D, La Carrubba S, Leonetti S, Montericcio V, Tota A, Petrella L. Imaging of cardiac masses: An updated overview. J Cardiovasc Echogr 2022; 32:65-75. [PMID: 36249434 PMCID: PMC9558634 DOI: 10.4103/jcecho.jcecho_18_22] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 04/18/2022] [Indexed: 11/04/2022] Open
Abstract
Studying cardiac masses is one of the most challenging tasks for cardiac imagers. The aim of this review article is to focus on the modern imaging of cardiac masses proceeding through the most frequent ones. Cardiac benign masses such as myxoma, cardiac papillary fibroelastoma, rhabdomyoma, lipoma, and hemangioma are browsed considering the usefulness of most common cardiovascular imaging tools, such as ultrasound techniques, cardiac computed tomography, cardiac magnetic resonance, and in the diagnostic process. In the same way, the most frequent malignant cardiac masses, such as angiosarcoma and metastases, are highlighted. Then, the article browses through nontumoral masses such as cysts, mitral caseous degenerative formations, thrombi, and vegetations, highlighting the differential diagnosis between them. In addition, the article helps in recognizing anatomic normal variants that should not be misdiagnosed as pathological entities.
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14
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Horiguchi T, Nishikawa T, Shiokawa N, Imakiire R, Okamoto Y. Intermittent abdominal pain in cardiac tamponade due to pericardial cysts. Pediatr Int 2022; 64:e15056. [PMID: 35484907 DOI: 10.1111/ped.15056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/17/2021] [Accepted: 11/11/2021] [Indexed: 01/05/2023]
Affiliation(s)
- Tatushi Horiguchi
- Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takuro Nishikawa
- Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Naohiro Shiokawa
- Department of Pediatrics, Kagoshima City Hospital, Kagoshima, Japan
| | - Ryo Imakiire
- Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yasuhiro Okamoto
- Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
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15
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Jiménez Martínez C, España Barrio E, Sanz Merino AI, Robles Velasco P, Olmedilla Arregui P, Campuzano Ruiz R. Complete resolution of atypical pericardial cyst after acute pleuropericarditis. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2021; 74:1110-1112. [PMID: 34246601 DOI: 10.1016/j.rec.2021.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/05/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Carla Jiménez Martínez
- Servicio de Cardiología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain.
| | - Elena España Barrio
- Servicio de Cardiología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - Ana Isabel Sanz Merino
- Servicio de Radiología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - Pablo Robles Velasco
- Servicio de Cardiología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | | | - Raquel Campuzano Ruiz
- Servicio de Cardiología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
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Terry NLJ, Manapragada PP, Aziz MU, Singh SP. Review of pericardial disease on computed tomography. J Med Imaging Radiat Sci 2021; 52:S65-S77. [PMID: 34588141 DOI: 10.1016/j.jmir.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/23/2021] [Accepted: 09/10/2021] [Indexed: 10/20/2022]
Abstract
Echocardiography has long been the mainstay in the evaluation of cardiac and pericardial disease. As computed tomography (CT) has advanced, it has become a valuable partner in the imaging of the pericardium. The advantages of CT include a larger field of view, multiplanar reconstruction and increased discrimination between various soft tissues and fluids. CT is less operator dependent and can more easily, and reproducibly, image areas of the pericardium for which echocardiography has poor windows such as the right pericardium. The introduction of EKG gating has decreased cardiac motion artifact and can allow functional evaluation although echocardiography remains the primary source of real-time imaging of cardiac and valve motion. It is essential for the skilled cardiac imager to understand the strengths and weaknesses of CT and its role in the definition and assessment of pericardial disease.
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Affiliation(s)
- Nina L J Terry
- University of Alabama at Birmingham, Department of Radiology, Birmingham, AL, USA.
| | - Padma P Manapragada
- University of Alabama at Birmingham, Department of Radiology, Birmingham, AL, USA
| | - Muhammad Usman Aziz
- University of Alabama at Birmingham, Department of Radiology, Birmingham, AL, USA
| | - Satinder P Singh
- University of Alabama at Birmingham, Department of Radiology, Birmingham, AL, USA
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17
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Abstract
PURPOSE OF REVIEW Tumors of the pericardium are rare, but a wide variety of congenital, infectious, inflammatory, and neoplastic processes have been reported. Pericardial tumors can be categorized as non-neoplastic or neoplastic. Neoplastic lesions can be further divided into benign or malignant, with malignancies being either primary or secondary (metastatic). Clinical, radiographic, and pathologic features of the most common entities are discussed. RECENT FINDINGS Metastatic neoplasms involving the heart and pericardium are far more common than primary pericardial neoplasms. Of primary pericardial malignancies, mesothelioma is the most common; notably, cytology of effusion fluid is relatively insensitive to the diagnosis. The prognosis for most malignancies of the pericardium, primary or secondary, is poor. Increasingly, clinically recognized diseases that involve the pericardium include Erdheim-Chester and IgG4-related disease. This article provides a comprehensive review of the most recent literature to develop a structured framework to the differential diagnosis of pericardial tumors.
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18
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[Complete resolution of atypical pericardial cyst after acute pleuropericarditis]. Rev Esp Cardiol 2021; 74:1111-1113. [PMID: 34099949 PMCID: PMC8172354 DOI: 10.1016/j.recesp.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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19
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Abstract
OBJECTIVES Peritoneal mesothelial cysts have been reported under various terms, including benign cystic mesothelioma, usually in the form of case reports/series, whereas extraperitoneal cases are rarely reported. Our objective was to report the detailed characteristics of cystic lesions of the serosal cavities. METHODS We retrospectively examined the clinicopathologic findings of a series of mesothelial cystic lesions (n = 79). RESULTS Most cases (n = 68, 86%) concerned the peritoneum, whereas 11 (14%) concerned the pericardium. No pleural cases were found. A total of 51 (64.5%) lesions were solitary, whereas 28 (35.5%) were multiple. Peritoneal lesions harbored a plump eosinophilic mesothelium and a loose connective stroma, whereas pericardial lesions showed a cuboidal/flattened mesothelium, collagenous stroma, intense inflammation, and other tissue types, like adipose and muscle tissue. Solitary peritoneal lesions are usually extrapelvic and found in older patients incidentally during other surgeries, whereas multiple lesions are found in younger patients and usually in the pelvis. The lesions show a benign clinical course with rare recurrences but no malignant transformation. CONCLUSIONS Most mesothelial cysts are peritoneal and rarely pericardial. Peritoneal cysts differ from pericardial cysts. Peritoneal solitary lesions differ from multiple lesions, also suggesting their pathogenetic differences.
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Affiliation(s)
- Georgia Karpathiou
- Pathology Department, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Francois Casteillo
- Pathology Department, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Maroa Dridi
- Pathology Department, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Michel Peoc’h
- Pathology Department, University Hospital of Saint-Etienne, Saint-Etienne, France
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20
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Chetrit M, Parent M, Klein AL. Multimodality imaging in pericardial diseases. Panminerva Med 2021; 63:301-313. [PMID: 33618512 DOI: 10.23736/s0031-0808.21.04270-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
With a rapidly growing spectrum, non-specific symptoms and overlapping etiologies, pericardial diseases can represent a real diagnostic challenge. Consequently, multimodality imaging has taken a front seat in the diagnosis and management of these conditions. Cardiac CT offers an excellent anatomical characterization of pericardial thickening, fat stranding and/or presence of calcifications. and is also the preferred modality to assess extra-cardiac structures. Active pericardial inflammation, edema and fibrosis comprise pericardial characterization using CMR and allows for a precise diagnosis, disease staging and patient specific tailoring of therapies. PET scan still occupies a very modest role in the evaluation of pericardial diseases, but might help discriminating malignant pericardial effusion and extra-pulmonary tuberculous. More than ever, clinicians need to master how these modalities complement each other while avoiding unnecessary cost and to translate this knowledge into a more customized patient's care approach. The aim of this review is to recognize the role of multimodality imaging in the investigation of various pericardial diseases, assess how these modalities can impact the clinical course and treatment of these affections and finally elucidate their role in the patient's prognostication.
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Affiliation(s)
- Michael Chetrit
- Department of Cardiovascular Medicine, McGill University, Montreal, Canada
| | - Martine Parent
- Department of Cardiovascular Medicine, McGill University, Montreal, Canada
| | - Allan L Klein
- Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Cleveland Clinic, Cleveland, OH, USA - .,Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA
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21
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Liu J, Lv Q, Wang J, Zhang L, Xie M, Yang Y. Diagnostic value of echocardiography in paracardiac cystic lesions: 43 cases from one single medical center. Int J Cardiovasc Imaging 2021; 37:1961-1966. [PMID: 33620608 PMCID: PMC8255260 DOI: 10.1007/s10554-021-02180-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 01/30/2021] [Indexed: 12/25/2022]
Abstract
Paracardial cystic lesions (PCLs) are rare, benign lesions and may occur in any part surrounding the heart. It covers a variety of pathological types, including pericardial cysts, thymic cysts, bronchogenic cysts and so on. The aim of this study was to summarize the diagnostic value of echocardiography in different pathological types of the PCLs. Echocardiographic features of 43 consecutive PCL patients treated at the Union Hospital from January 2002 to December 2017 were compared and analyzed with their surgical and pathological findings retrospectively. The PCLs included 19 pericardial cysts, 12 thymic cysts, 7 bronchogenic cysts, 3 cystic teratomas, 1 enteric cyst and 1 lymphangioma. Among them, 29 cases (67.4%) were accurately diagnosed by echocardiography and 14 cases (32.6%) were missed the diagnosis. All diagnosed cysts were showed as thin-walled, monolocular, echo-free structures without blood flow signals in echocardiographic images. 4 patients had compression of the heart and great vessels caused by cysts. In addition, 4 intracardiac lesions were diagnosed by echocardiography and the results were further confirmed in surgery. Echocardiography is of great value in the diagnosis of paracardiac cystic lesions as well as combined intracardiac lesions. Differential diagnosis could be mainly made based on the location of the lesions.
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Affiliation(s)
- Jinfeng Liu
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Department 3 of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Qing Lv
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Jing Wang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Li Zhang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Mingxing Xie
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
| | - Yali Yang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
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22
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Alex A, Ayyappan A, Valakkada J, Pillai VV, Sreekantan R, Poyuran R. Pericardial pseudocyst along atrioventricular groove. BJR Case Rep 2020; 7:20200122. [PMID: 33841901 PMCID: PMC8008468 DOI: 10.1259/bjrcr.20200122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 11/22/2022] Open
Abstract
Cystic lesions in relation to the pericardium are a rare congenital lesion with an estimated incidence of 1 per 100,,000. Pericardial cysts may be classified as congenital or acquired. Here, we present a case of a pericardial pseudocyst having a horseshoe configuration along the atrioventricular groove in a middle-aged subject with no previous relevant medical history. The patient underwent open surgery for the same with histopathological diagnosis being established. This paper highlights the differentials for a cystic pericardial lesion in imaging in addition to the histopathological entity of a pericardial pseudocyst.
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Affiliation(s)
- Ajay Alex
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Anoop Ayyappan
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Jineesh Valakkada
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Vivek V Pillai
- Department of Cardiovascular & Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Renjith Sreekantan
- Department of Cardiovascular & Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Rajalakshmi Poyuran
- Department of Pathology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
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23
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Lak H, Shah R, Verma BR, Xu B. A rare complication of a rare disease: Pericarditis due to ruptured pericardial cyst. Echocardiography 2020; 37:1300-1303. [DOI: 10.1111/echo.14714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/06/2020] [Accepted: 05/08/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- Hassan Lak
- Department of Medicine Cleveland Clinic Cleveland OH USA
| | - Rohan Shah
- Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute Cleveland Clinic Cleveland OH USA
| | - Beni R. Verma
- Department of Medicine Cleveland Clinic Cleveland OH USA
| | - Bo Xu
- Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute Cleveland Clinic Cleveland OH USA
- Section of Cardiovascular Imaging Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute Cleveland Clinic Cleveland OH USA
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24
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Raja Shariff REF, Kasim S. Massive intrapericardial cyst: A rare cause of chronic cough. PROCEEDINGS OF SINGAPORE HEALTHCARE 2020. [DOI: 10.1177/2010105820924062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We present a unique case of massive intrapericardial cyst manifesting as chronic cough, which highlights the unique presentation of this rare condition. Although uncommon, intrapericardial cyst should be considered in cases of chronic, non-productive cough, especially in the absence of lung pathology. The role of multi-modality imaging remains essential for early detection of the condition and monitoring for potential complications.
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