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Misdiagnosis of pericardial cyst by echocardiography and computed tomography scanning
Insights
A patient with right-sided heart failure was misdiagnosed due to incorrect interpretation of imaging tests for an intracardiac mass. Surgery revealed a pericardial cyst compressing the heart, highlighting potential diagnostic challenges.
Area of Science:
- Cardiology
- Radiology
- Cardiac Surgery
Background:
- Right-sided heart failure presents with specific clinical signs.
- Intracardiac masses are a differential diagnosis for such presentations.
- Noninvasive imaging modalities are crucial for initial evaluation.
Observation:
- A patient presented with clinical manifestations of right-sided heart failure.
- Echocardiography and computed tomography suggested an intracardiac mass.
- Surgical exploration was performed for definitive diagnosis.
Findings:
- The "intracardiac mass" was identified as a pericardial cyst.
- The cyst was externally compressing the right ventricular cavity.
- This led to the clinical signs of heart failure.
Implications:
- Noninvasive imaging is valuable but prone to interpretation errors in diagnosing cardiac masses.
- Misdiagnosis is possible, necessitating careful correlation of imaging findings with clinical presentation.
- Pericardial cysts should be considered in the differential diagnosis of right ventricular compression.
Abstract:
We saw a patient who had clinical features of right-sided heart failure. Echocardiography and computed tomography findings were incorrectly interpreted as demonstrating an intracardiac mass. At surgery, a pericardial cyst externally compressing the right ventricular cavity was found. We conclude that, although noninvasive tests may play a valuable role in evaluating intracardiac masses, interpretation may be difficult and misdiagnoses are possible.