Clinical Practice and Cases in Emergency Medicine

Pericardial cysts were first described in 1837 as diverticula extending from the pericardium. They are rare and frequently asymptomatic. Symptomatic presentations may be similar to more common causes of chest pain or dyspnea such as acute coronary syndrome or pulmonary embolism. Emergency physicians should consider mediastinal mass, and in this case pericardial cyst, in the differential diagnosis of chest pain because of the risk for tamponade, sudden cardiac death, or other life-threatening complications. Here, we describe a novel presentation of a pericardial cyst presenting as atypical chest pain.