Is there something like a water bubble near your heart? Let's learn about this (Pericardial Cyst)!

Sometimes, small things can develop inside our bodies without us even realizing it, right? That's what this `(Pericardial Cyst)` is. When you hear this name, it may seem like a big deal, but don't worry , most of the time it's not that dangerous. Today, we'll talk about this simply, in a way that you can understand.

What is this `(Pericardial Cyst)`?

Simply put, a Pericardial Cyst is a fluid-filled cyst that forms in the thin sac-like membrane that surrounds your heart, the pericardium. It looks like a water bubble. Most of the time, it's a congenital condition. These cysts are usually about 3 to 5 centimeters in size, which is about an inch and a half to two inches. But some can be larger. They can be round or slightly oblong in shape. They contain a clear fluid. That's why in the past, in the 1940s, doctors also called them "spring water cysts." They are most often found on the right side of the heart. The most important thing is that these Pericardial Cysts are not cancerous. Most people don't show any symptoms. But imagine, if this tumor grows a little and presses on the heart or nearby lungs, then there is a possibility that some symptoms or complications may occur.

How serious can a `(Pericardial Cyst)` be?

Usually, a `(Pericardial Cyst)` does not cause much trouble. Many people live without even knowing they have it. However, very rarely, and that means very rarely, complications such as these can occur:

• Heartbeat irregularities ( Arrhythmia ): An irregular heartbeat .
• Cardiac tamponade : This can be an emergency.
• Constrictive pericarditis: The heart cannot function properly.
• Heart failure .
• Fainting / syncope .
• Pneumonia .
• Blockage of the blood flow from the right ventricle of the heart`(Right ventricular outflow tract obstruction)`.
• Sudden cardiac death : This is very rare.
• Superior vena cava syndrome (SVCS) is a condition caused by compression of the superior vena cava (a blood vessel) .

These names may seem scary, but remember that these are very rare occurrences.

Who is most affected by this situation?

This condition called `(Pericardial Cyst)` can actually develop in anyone of any age. Imagine, even a person as old as 102 years old has been diagnosed with it. Sometimes, even a small child in the mother's womb can be diagnosed with it through `(prenatal testing)` during pregnancy. However, it is most often diagnosed in young adults, that is, in people between the ages of 20 and 40. It is also said that women are slightly more likely to develop this condition than men. If we talk about how common it is, `(Pericardial Cyst)` is a somewhat rare condition. It affects about one in a hundred thousand people.

What are the symptoms of a `(Pericardial Cyst)`?

The good news is that not everyone with this condition has symptoms. In fact, about three out of four people don't experience any symptoms at all. However, as mentioned earlier, if this tumor gets big enough to press on your heart or lungs, you may experience symptoms like:

• Chest pain: This pain may also spread to upper parts of the body, such as the neck, shoulders, and arms.
• Cough: You may have a persistent cough.
• Frequent respiratory infections : For example, lung infections.
• Difficulty breathing (dyspnea): You may feel like you are gasping for breath even with a small amount of activity.

How does this `(Pericardial Cyst)` form?

Most of the time, that is, more than 90% of cases, this `(Pericardial Cyst)` is something that is present at birth `(congenital)`. That is, this cyst is formed due to a slight weakness in the formation of the protective membrane `(pericardium)` around the heart during fetal life, while in the mother's womb. There are other very rare causes for this. They are:

• Inflammation of the heart membrane, a condition called ``pericarditis''.
• Due to a severe injury to the chest (trauma).

How do you know if you have a `(Pericardial Cyst)`?

This is the most amazing thing. Most of the time, doctors find this `(Pericardial Cyst)` by accident!This means that you may only find this lump when you have a chest X-ray or other scan for some other reason. That's why doctors call these findings "incidental findings." When a lump is found like this, the doctor will do several more tests to make sure it's a pericardial cyst. They also want to make sure it's not another serious condition. For example:

• An aneurysm is a bulge in a blood vessel in the lower chamber of the heart.
• A hernia in the diaphragm (the muscle that separates the chest and abdomen) (Morgagni hernia).
• Other types of cysts or tumors.

What kind of tests confirm this?

Doctors use tests like these to accurately diagnose and monitor this ``Pericardial Cyst'' condition:

• Cardiac CT scan : This can take a clear picture of the tumor, as well as the condition of the pericardium.
• Cardiac MRI scan : This can be used to see if the tumor is pressing on the heart, lungs, or other nearby vital organs.
• Echocardiography : This is like an ultrasound scan of the heart. It is used to see if the size of the tumor is changing over time and to guide aspiration of fluid from the tumor if necessary.

What are the treatments for `(Pericardial Cyst)`?

The good news is that in most cases, a Pericardial Cyst does not require major treatment. Doctors call this 'conservative management'. That means, don't panic, just observe.

• Monitoring: If you have no symptoms and the tumor is not getting bigger, your doctor will monitor the tumor with a transthoracic echocardiogram (TTE) every few years. No other treatment is needed.
• When treatment is needed: However, if you start to experience symptoms, or if scans show that the tumor is getting bigger, then treatment will be necessary.

There are two main methods of treatment: 1. Removal of fluid through minimally invasive procedures:

• Ethanol sclerosis : In this, a substance called ethanol is injected into the tumor, and then the fluid in the tumor is removed. This reduces the risk of the tumor growing back.
• Percutaneous aspiration : A needle is inserted through a small hole in the skin and all the fluid in the cyst is removed.

2. Surgical removal of the tumor:

• Laparoscopic surgery : This involves making several very small incisions in the chest and using a camera and delicate instruments to remove the tumor. This is also called "keyhole surgery."
• Median Sternotomy : A surgery that involves making an incision in the middle of the chest, down the breastbone. This is a major operation.
• Thoracotomy : A surgical procedure that involves making an incision between two ribs.
• Video-assisted thoracic surgery (VATS): This is similar to laparoscopic surgery, in that it is performed using a camera through a small incision made between the ribs.

Your doctor will review your condition, discuss all of these treatment options with you, and decide which is best for you and the safest . The main goal of these treatments is to prevent serious complications that can occur if the tumor presses on the heart or lungs.

Can these be prevented from occurring?

Since pericardial cysts are usually congenital , there is really nothing we can do to prevent them from forming. However, if you have previously had pericarditis, an inflammation of the lining of the heart, you may be at a slight risk of developing a pericardial cyst. It is a good idea to talk to your doctor about this.

Is a Pericardial Cyst dangerous?

Again, most pericardial cysts are not dangerous. They can only be dangerous if they put pressure on the heart, lungs, or other nearby vital organs. If you have a pericardial cyst, your doctor will monitor it and treat it if and when necessary. So don't be unnecessarily scared.

What happens if I have this condition? How will it be going forward?

Most people with a pericardial cyst can recover well and live a normal life . However, if you have symptoms or your cyst is getting bigger, you may need treatment to prevent the complications mentioned above. Talk openly with your doctor about your condition, the prognosis, and your risk of complications.

When should I see a doctor? What should I be concerned about?

Be sure to get your annual checkups . Also, attend follow-ups as directed by your doctor. Remember, many people don't know they have a Pericardial Cyst, because it's often discovered by chance. Therefore, it's important to attend all of your doctor's appointments and tests. Then, you're more likely to find a Pericardial Cyst before it becomes a problem.

Especially remember, if the doctor has aspirated the fluid from your `(Pericardial Cyst)`, there is approximately a 30% chance that the cyst will come back. Therefore, follow-up tests are essential. The doctor will need to monitor you to see if the cyst comes back.

Emergency! If you have these symptoms, it could be a sign of cardiac tamponade.Call 911 or your local emergency department immediately, or go to a hospital immediately:

• Sudden change in mental status (feeling confused, agitated, loss of consciousness).
• Feeling dizzy or fainting/fainting.
• A sharp, stabbing pain in the chest. This pain may spread to the stomach, back, neck, arm, or shoulder.
• Increased breathing rate.
• Excessively rapid pulse.
• Skin discoloration (pale, gray, or blue).
• Severe difficulty breathing.

So, what are the things we need to remember? (Take-Home Message)

Although this condition called `(Pericardial Cyst)` may sound scary, most of the time it does not show any symptoms, and it rarely causes serious complications. But if you have symptoms, or if the cyst is getting bigger, do not worry. Modern medicine has several good treatments for this. Talk to your doctor carefully about what treatment is best for you and how long it will take to recover. The most important thing is to follow your medical tests and medical advice. Then, even if you have a condition like this, you can recognize it early, do what is necessary, and stay healthy. Pericardial cyst, heart cyst, pericardial cyst, chest pain, difficulty breathing, heart disease, pericardial