Year : 2018  |  Volume : 12  |  Issue : 3  |  Page : 45-48

Tamponade-like picture caused by pericardial cyst

Department of Cardiothoracic Anesthesia, Freeman Hospital, Newcastle Upon Tyne, UK

Correspondence Address:
Mostafa Eladawy
Department of Cardiothoracic Anesthesia, Freeman Hospital, Newcastle Upon Tyne
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ejca.ejca_17_18

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Pericardial cysts are rare entities, they have an incidence rate of 1:100,000 which constitutes about 7.6% of all mediastinal masses (6). The differential diagnosis includes other solid tumors and cysts of the mediastinum, diaphragmatic hernia or tumors, aneurysms of the heart or great vessels (1). Although TTE can differentiate many of the causes of mediastinal masses, loculated pericardial effusion with a similar clinical picture can be difficult to differentiate on transthoracic echocardiography (8). Radiological examination with CT or MRI has been described to differentiate in difficult cases. In emergency situations, TEE examination could be a useful option as it can help differentiating a malignant from a benign pericardial cyst, check the extent of involvement of underlying myocardium or adjacent structures and assess the anatomical abnormalities or effects on different heart chambers. In our case we describe a case of a huge pericardial cyst which had affected the patient haemodynamics in a tamponade like picture, the intra-operative TEE assessment helped appreciating the compression effect on the right heart chambers and the intravascular resuscitation needed to counteract the external pressure of the pericardial cyst. The echocardiography also helped the decision making of performing the procedure on CPB.

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