Estatísticas

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      "titulo" => "Unearthing an interrupted aortic arch in an elderly patient &#8211; Listen&#44; watch and feel"
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        "titulo" => "Um caso raro de dispneia"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">First transthoracic heart echocardiogram &#40;parasternal long axis view&#41; depicting an echolucent mass at the site of pericardium&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 70-year-old woman&#44; who had a history of dyslipidemia and coronary artery disease&#44; was referred to our cardiology clinic for dyspnea that had deteriorated over the last two months&#46; Her vital signs were normal with no significant findings in clinical examinations and laboratory tests&#46; The initial transthoracic heart echocardiogram showed an echolucent mass at the site of pericardium from a parasternal long axis view &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46; The patient underwent a chest X-ray&#44; which confirmed the presence of a giant mass of the middle mediastinum &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>&#41;&#46; An urgent thorax and abdomen contrast computed tomography was performed during the diagnostic work-up&#46; The mass turned out to be an enormous pericardial cyst &#40;6&#46;6 cm &#215;14&#46;7 cm&#41; located at the right cardiophrenic angle&#44; causing atelectasis of the right middle and lower lung lobe &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>&#44; <a class="elsevierStyleCrossRef" href="#sec0015">video</a>&#41;&#46; The patient was referred to a cardiac surgeon for thoracoscopic resection of the cyst&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Pericardial cysts are uncommon benign&#44; usually asymptomatic&#44; middle-mediastinal masses&#46; Most of them are found incidentally during chest X-ray or echocardiography&#46; The size varies from 2 to 28 cm<span class="elsevierStyleSup">2</span>&#46; A watchful waiting approach is recommended&#46; Intervention is indicated when they cause symptoms &#40;chest pain&#44; dyspnea&#44; recurrent cough&#44; tamponade or ventricular outflow tract&#41;&#46; Thoracoscopic resection is the treatment of choice&#44; with percutaneous aspiration being an alternative when there is a high associated surgical risk&#46; In our case&#44; it is quite impressive that such a large pericardial cyst &#40;97 cm<span class="elsevierStyleSup">2</span>&#41;&#44; one of the largest cysts described in the literature&#44; took so long to become symptomatic&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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