Pericardial Cyst: A Review of Historical Perspective and Current Concept of Diagnosis and Management

Pericardial cysts are very rare disorder with an incidence of about 1 in 1, 00,000. Pericardial cyst and diverticulum share similar developmental origin and may appear as an incidental finding in chest x ray in an asymptomatic patient. CT scan is considered as best modality for diagnosis and delineation of surrounding anatomy. Cardiac MRI is another excellent tool in diagnosis and evaluation of compressive effect and diffusion weighted cardiac MRI are very helpful for cases with diagnostic confusion. Echocardiography is best modality for follow up and image guided aspiration of the cyst. Conservative management with regular follow up may be considered if the cyst is small, patient is asymptomatic and probability of subsequent complication is low. Surgical resection should be considered in symptomatic patients, large cysts and with high probability of complications. Percutaneous aspiration and ethanol sclerosis is another attractive option.