Pericardial Cyst: Unexpected Finding on a Chest Radiograph

A 32-year-old female presented to the emergency department after a motor vehicle collision with complaints of thoracic back pain. Further history was not obtainable owing to marked ethanol intoxication. Vital signs and physical examination were unremarkable except for a mild tachycardia, which resolved with intravenous fluids. A chest radiograph was obtained (Figure 1). Medical records’ review revealed that the same abnormality had been noted 17 months earlier (Figure 2). DIAGNOSIS Most pericardial cysts are congenital, forming during embryogenesis from a persistent parietal recess. They are uncommon, with an estimated prevalence of 1 in 100,000 population. Approximately 1 in 6 patients are symptomatic with complaints of chest pain or dyspnea. Pericardial cysts may cause cardiac compression and may enlarge over time. They are easily seen on routine chest radiographs and may be an incidental finding as in our case. Diagnosis is confirmed