Pericardial Cyst Symptoms, Causes, Removal, Management

Pericardial cyst is a congenital disease. It do not have clinical significance but can only be observed during incidental findings. It is a rare finding i.e 1 case in every 1000 people. It occurs in middle mediastinum and rarely in the anterior and posterior superior mediastinum. People with pericardial cyst may experience chest pain, chest heaviness, dyspnea and persistent cough. More than 50 percent cases of pericardial cyst are asymptomatic. Pericardial cyst may occur secondary to previous pericarditis. Pericardial cyst is covered with connective tissues and thin layer of mesothelial cells. These mesothelial cells are filled with clear fluid.

Pericardial Cyst Symptoms

Pericardial cyst are asymptomatic in more than 50 percent of cases. But in rare cases it show some symptoms. Common symptoms involve chest heaviness, shortness of breath, persistent cough and pain in chest. These symptoms do not clearly help in diagnosing pericardial cyst. In asymptomatic cases of pericardial cyst, it is diagnosed during incidental findings. Pericardial cyst may cause further complications like cardio pulmonary complications. Obstruction in main stem of bronchus at right side, obstruction in ventricular outflow, stenosis in pulmonary artery arrhythmias and cardiac temponade (proved fatal in most of the cases) are the common complications.

Pericardial Cyst Symptoms, Causes, Removal, Management

Pericardial Cyst Causes

Pericardial cyst formation may result from aberration in the formation of coelomic cavities. It is a benign congenital disease, so there is no specific acquired cause behind it. Previously present pericarditis may result in pericardial cyst.  Pericarditis is the inflammation of pericardium. Pericardium is the outer covering of heart which protects it. Cysts formed in pericardium have outer covering of connective tissues. Along with connective tissues, a thin single layer of mesothelial cells is present. The cells of mesothelial layer contain clear transparent fluid in them. There is no other cause reported behind pericardial cyst other than pericarditis because it is a very rare condition.

Pericardial Cyst Removal

Pericardial cyst can be removed via surgery. Surgery recommended for this purpose is percutaneous aspiration guided by echo cardiograph or thoracoscopic surgery with visual assistance. These both surgeries can be performed side by side. Thoracotomy or conservative therapy are also performed for removal of pericardial cyst. Removing pericardial cyst is a very sensitive procedure and require echo cardiograph or visual assistance for successful surgery. A thoracoscope is inserted with a ring clamp on it. With visual assistance, the cyst can be clearly seen and picked via ring clamp. The distance between cyst and pericardial wall is little, so care is required while removing cysts.

Pericardial Cyst Management

Management of pericardial cyst involve conservative therapy. Follow up is an important factor in managing pericardial cyst. To make management plan economic, it is recommended to treat pericardial cysts via ethanol sclerosis and percutaneous aspiration. Thoracotomy or surgery is considered 2nd line therapy for pericardial cyst. It is designed so because percutaneous aspiration and ethanol sclerosis are more safe and effective as compared to surgery or thoracotomy. Patient have to go through imaging tests on every follow up. So on the basis of collected data, it is roughly estimated that ethanol sclerosis show no recurrence in 6 months of treatment follow up.
Pericardial Cyst Symptoms, Causes, Removal, Management Pericardial Cyst Symptoms, Causes, Removal, Management Reviewed by Simon Albert on August 03, 2017 Rating: 5
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