A Giant Pericardial Cyst With Uncommon Presentations in a Woman After Treated COVID-19 Infection: A Rare Case Report

Pericardial cysts are a scarce cause of mediastinal masses. They are usually asymptomatic, even in large sizes. Accurate diagnosis of pericardial cysts is possible with multiple diagnostic imaging modalities. A 41-year-old woman complaining of bilateral lower limb edema, exertional dyspnea, and recurrent palpitations was admitted to our emergency department. She had experienced a syncope state. Echocardiography showed a reduced right-side heart function due to a large cystic-like mass at the supradiaphragmatic right paracardiac region with a compressive effect on the right heart. A computed tomography scan confirmed the presence of a giant pericardial cyst. The patient underwent cardiac surgery to excise the mass, 15×13.5×3.5 cm in size. This case report shows that huge right-sided pericardial cysts must be considered in the differential diagnosis of right-sided heart failure. The preferable and reasonable approach to a patient with a huge pericardial cyst is surgical excision for symptom alleviation, early identification, and removal. (Iranian Heart Journal 2022; 23(4): 109-114)