Ventricular Aneurysm Complicated by Hemorrhagic Pericardial Effusion Following Thymic Cyst: A Case Report

Abstract

This study reports a case of a 70-year-old woman who developed a ventricular aneurysm and hemorrhagic pericardial effusion following thymic cyst surgery. A preoperative chest CT scan revealed an abnormal mediastinal shadow measuring approximately 31 × 20 × 52 mm, which was confirmed postoperatively as a thymic cyst by pathological examination. One month after surgery, the patient experienced chest tightness. A follow-up CT scan showed an increase in cystic and pericardial effusion, now measuring 58 × 43 × 76 mm. Pericardiocentesis drained approximately 1300 ml of dark red, non-clotting blood. Echocardiography revealed an aneurysm at the apex of the interventricular septum, while coronary CT showed no abnormalities. Four months later, the patient developed increased right-sided pleural effusion, and approximately 800 ml of light red fluid was drained via ultrasound-guided thoracentesis. Based on the patient's clinical course and echocardiographic findings, the hemorrhagic effusion associated with the ventricular aneurysm is likely secondary to the thymic cyst surgery.