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Are all Pericardial Cysts asymptomatic??

Pericardial Cysts are very rare entities (1/100,000 individuals), due to a congenital defect in the lining around the heart.  The current medical management is to “watch” this entity and not recommend surgery unless it is clearly causing the symptoms due to the size of the “cyst” and compression of other organs in the chest.  It is routinely felt that they do NOT cause symptoms and complaints from patients are due to stress or anxiety.  However, not all “pericardial cysts” are really separated from the pericardium and may still be attached with an opening large enough to allow fluid to pass from the pericardium to the cyst and vice versa.  This may happen 10% of the time and the entity is then known as a “Pericardial Diverticulum”.  Current diagnostic studies are unable to distinguish the difference between a pericardial cyst and a diverticulum.  A patient diagnosed with a “pericardial cyst” for 30 years was actually diagnosed as having a diverticulum at the time of surgery. She had experienced 30 years of atypical chest discomfort.  The symptoms did resolve by a surgical procedure, removing the pericardium. Please feel free to download Dr. Money’s case report and literature review to read more.     Download PDF pericardial diverticulum paper case report

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