Author + information
- Received January 27, 2013
- Accepted February 19, 2013
- Published online September 3, 2013.
- Fabian Islas, MD∗,
- Jose Alberto de Agustin, MD, PhD∗,
- Jose Juan Gomez de Diego, MD, PhD∗,
- Carmen Olmos, MD∗,
- Carlos Ferrera, MD∗,
- María Luaces, MD, PhD∗,
- Beatriz Cabeza, MD†,
- Carlos Macaya, MD, PhD∗ and
- Leopoldo Pérez de Isla, MD, PhD∗
A 73-year-old man was admitted to our hospital because of sudden loss of consciousness. Chest x-ray revealed an unusual bulge on the left cardiac border (A). Transthoracic echocardiography showed a large extrinsic echo-free space located in the anterior mediastinum between the heart and the sternum edges causing compression of the left ventricular free wall during the whole cardiac cycle (B, C, and D, asterisk; Online Videos 1, 2, and 3). Doppler echocardiography showed marked respiratory variations in transmitral diastolic flow (E). Color Doppler imaging showed no flow inside the lesion. These findings were consistent with pericardial cyst. Three-dimensional echocardiography supported these findings (F). Cardiac magnetic resonance was performed and demonstrated a large (8 × 7 × 4 cm) thin-walled homogenous lesion within the anterolateral aspect of the left cardiac border (G, Online Videos 4 and 5), hypointense on T1-weighted images (H) and hyperintense on T2-weighted images (I), consistent with pericardial cyst. Cardiac surgery was recommended, but the patient declined. LA = left atrium; LV = left ventricle; RV = right ventricle.
- Received January 27, 2013.
- Accepted February 19, 2013.
- American College of Cardiology Foundation