CASE REPORT article
Front. Cardiovasc. Med.
Sec. General Cardiovascular Medicine
Beyond Rhythm Disorder: A Rare Case Report of a Young Patient with Mediastinal Bronchogenic Cyst
Monika Ivanova Shumkova 1,2
Kristina Stoyanova 2,1
Ivan Andreev 1,2
Raia Ivanova 1,2
Kiril Karamfiloff 1,2
1. UMHAT "Alexandrovska", Cardiology clinic, Sofia, Bulgaria
2. Medical University Sofia, Sofia, Bulgaria
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Abstract
Abstract Background Mediastinal bronchogenic cysts are sporadic congenital tumors, approximately 10-15% of all mediastinal masses. In most cases, they remain asymptomatic. We present a case for a young adult with new-onset atrial fibrillation caused by extracardiac compression of the left atrium by mediastinal bronchogenic cyst. We report the first documented case in our country of a mediastinal bronchogenic cyst presenting with cardiac symptoms. Case summary A 39-year-old man was admitted to the emergency department with palpitations, dyspnea, and tachycardia that started after physical activity. Electrocardiography showed the first episode of atrial fibrillation. Echocardiography revealed an oval echolucent mass compressing the left atrium. Cardiac magnetic resonance imaging showed a massive mediastinal bronchogenic cyst causing compression of the left atrium, right inferior pulmonary vein, and esophagus, which was displaced to the left side. Robot-assisted thoracoscopic (RATS) surgery was planned and done successfully. Discussion Although typically asymptomatic, bronchogenic cysts can acutely present with life-threatening complications, especially when they compress important cardiovascular structures. This case highlights the important role of comprehensive evaluation in young patients. It is crucial to consider extracardiac causes in new-onset atrial fibrillation, especially in young adults. Fast and accurate diagnosis is essential for preventing further complications. Sometimes, restoring sinus rhythm is not the final step in the management.
Summary
Keywords
Atrial Fibrillation, cardiac magnetic resonance imaging, case report mediastinal bronchogenic cyst, congenital heart disease, keyword1, keyword2, keyword3, transthoracic echocardiography
Received
13 November 2025
Accepted
28 January 2026
Copyright
© 2026 Shumkova, Stoyanova, Andreev, Ivanova and Karamfiloff. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Monika Ivanova Shumkova
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