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Ann Thorac Surg 1999;67:1789-1791
© 1999 The Society of Thoracic Surgeons

Case Reports

Mediastinal bronchogenic cyst manifesting as a catastrophic myocardial infarction

Gregory A. Kennebeck, MDa, Andrew K. Wong, MDa, William R. Berry, MDa, John P. Higgins, MDb, Sergio M. Manubens, MDa

a Divisions of Cardiology and Cardiothoracic Surgery, David Grant Medical Center, Travis AFB, Stanford, California, USA
b Department of Pathology, Stanford University, Stanford, California, USA

Accepted for publication November 9, 1998.

Address reprint requests to Dr Wong, Division of Cardiology, SGOMC, David Grant Medical Center, 101 Bodin Circle, Travis AFB, CA 94535
e-mail: andrew.wong{at}60mdg.travis.af.mil

Congenital bronchogenic cysts of the lung and mediastinum develop from the ventral foregut during embryogenesis. These cysts are often incidental radiologic findings in adults, but patients can be seen with symptoms of chest pain, cough, dyspnea, or any combination of these. Acute presentations are unusual and have rarely been reported. We present the unique case of a 36-year-old man seen with an acute coronary syndrome and sudden hemodynamic collapse. The patient sustained a massive and ultimately fatal myocardial infarction, compression of the left main coronary artery by a bronchogenic cyst was demonstrated at postmortem examination. If detected, bronchogenic cysts should be surgically excised to limit associated morbidity and mortality.




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