Fibrous Pericardial Mass Signifying the Importance of Advanced Cardiovascular Imaging: A Case Report

Zaid A Abdulelah,1 Ahmed A Abdulelah,2 Abdulqader Alsayed Issa,3 Kais Al Balbissi4 1Department of Cardiology, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK; 2School of Medicine, University of Jordan, Amman, Jordan; 3Department of Cardiology, Abdali Hospital, Amman, Jordan; 4Divison of Cardiology, Department of Internal Medicine, School of Medicine, University of Jordan, Amman, JordanCorrespondence: Zaid A Abdulelah, Department of Cardiology, Royal Papworth Hospital NHS Foundation Trust, Papworth Road, Trumpington, Cambridge, CB2 0AY, UK, Email zaidaabdulelah@gmail.comBackground: Pericardial masses are an extremely rare group of diseases which can be classified based on etiology. The presentation of pericardial masses varies considerably from one individual to another, ranging from an asymptomatic presentation with an incidental finding on imaging, to presenting with non-specific signs and symptoms. Due to the enigmatic nature and presentation of pericardial masses, diagnostic imaging is mandatory.Case Presentation: A 69-year-old patient presented to our cardiology clinic complaining of intermittent shortness of breath upon moderate exertion in the absence of chest pain, paroxysmal nocturnal dyspnea, orthopnea, dizziness, palpitations, or lower limb edema. The patient’s past medical history was significant because of his history of pericarditis associated with pericardial effusion 6 years prior to presentation at our clinic. Despite adequate medical treatment, the patient complained of a relapsing and remitting pattern of symptoms that mandated the performance of advanced cardiovascular imaging, namely, cardiac magnetic resonance imaging, which revealed the presence of a profound pericardial mass.Conclusion: Despite the fact that relapsing pericarditis is a well-established complication following acute pericarditis, the presentation of a complication such as a fibrous pericardial mass evident on cardiac MRI has essentially been unreported in the literature previously.Keywords: pericardial mass, cardiovascular imaging, cardiac magnetic resonance imaging