Pericardial rupture of mediastinal mature cystic teratoma: An unusual cause of pediatric acute chest pain

Abstract

AbstractA previously healthy 12‐year‐old girl presented to the emergency department with severe chest pain and dyspnea that woke her from sleep. She had short‐term syncope just before the emergency admission. On physical examination, respiratory rate was 26 breaths per minute while resting, and blood pressure was 92/56 mmHg. Other physical examination findings were insignificant. She had no past medical history, and her family history was unremarkable. Laboratory test results showed elevated C‐reactive protein (27 mg/L; reference range: <5 mg/L) and white blood cell count (13.7 K/μL; reference range: 4–12 K/μL). Other laboratory test results were within normal limits, including troponin T value (3 ng/L; reference range: 3–14 ng/L). An electrocardiogram showed 1 mm ST‐segment elevation in bipolar (D1 and D2) limb leads, and augmented vector foot leads, and echocardiography revealed a complicated pericardial effusion and a suspicious mass adjacent to the left ventricle.