Pericardial cysts are rare mediastinal cysts and an uncommon cause of cough. Patients are often asymptomatic but can present with cough, dyspnea and atypical chest pain. We describe the case of a 30 year old female with a 3 month history of unexplained cough. Extensive workup and empiric treatment for the standard causes of cough were unsuccessful. More detailed workup including bronchoscopy, endoscopy, pulmonary function testing and otolaryngology evaluation was normal. Computed tomographic (CT) scan and Magnetic resonance imaging (MRI) of the chest revealed a 5.8 cm pericardial cyst in the left cardiophrenic angle. Video assisted thorascopic surgery (VATS) was performed for removal of the cyst and the cough resolved completely postoperatively.
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