Illustration of a bronchogenic cyst compressing the heart.

Rare Chest Cyst Causes Breathing Trouble: What You Need to Know

Beau Callahan in Health & Wellness July 2025 • 4 min read.

"A 48-year-old's breathing difficulties led doctors to discover a large bronchogenic cyst compressing his left atrium, highlighting the importance of investigating unusual respiratory symptoms."

Bronchogenic cysts are uncommon growths that develop in the chest, specifically in the mediastinum (the area between the lungs). Often, these cysts go unnoticed. In some instances, they can cause breathing problems, chest pain, or recurrent chest infections. While less frequent, these cysts can sometimes cause more severe problems. This article explores a fascinating case where a bronchogenic cyst had a direct impact on the heart.

Imagine a 48-year-old man, previously in good health, experiencing a gradual worsening of his breathing with exertion over eight months. Routine tests like physical exams, ECGs, lab work, and even chest X-rays came back normal. However, when doctors investigated further with an echocardiogram, they discovered a surprise: a sizable mass located behind the left atrium of his heart, compressing it.

This article delves into the diagnosis, treatment, and implications of this unusual case, drawing from a report by Theodoros Routoulas, Georgios Triantis, Nikolaos Smigadis, Panagiota Mylona, and Dimitrios Sionis from the Department of Interventional Cardiology and Cardiology Clinic at Sismanoglion Hospital in Athens, Greece.

When a Cyst Squeezes the Heart: Understanding the Impact

Illustration of a bronchogenic cyst compressing the heart.

Cardiac MRI revealed that the mass behind the heart was pressing against the left atrium, deforming its shape. This mass was located near the spine, below where the trachea splits. Measuring 5.5 x 4 x 3 cm, its position and structure suggested it was a bronchogenic cyst. This cyst was deforming the posterior wall of the left atrium, but aside from this, the rest of the patient's heart and respiratory system appeared normal.

The patient's progressive breathing difficulty was attributed to the compression of the left atrium caused by the cyst. Doctors opted for surgical removal of the cyst to alleviate the pressure on the heart.

The Surgical Success: The surgery to remove the bronchogenic cyst was successful, and the pathology report showed the cyst was not cancerous.
Recovery and Improved Heart Function: One year post-surgery, the patient remained free of symptoms. Follow-up tests showed his left ventricular diastolic function, which had been impaired due to the compression, had returned to normal.

This case underscores the importance of considering unusual causes when diagnosing breathing difficulties. While bronchogenic cysts are rare, their potential to compress vital structures like the heart can lead to significant health problems.

What Does This Mean For You? Key Takeaways on Bronchogenic Cysts

Bronchogenic cysts, while uncommon, can present with a range of symptoms, from being entirely unnoticed to causing significant respiratory or cardiac issues. This case highlights the importance of thorough investigation when faced with unexplained breathing difficulties.

While most bronchogenic cysts are benign (non-cancerous), their location can sometimes cause compression of vital structures, necessitating surgical removal. Early diagnosis and intervention can lead to a full recovery and resolution of symptoms.

If you experience persistent or worsening breathing difficulties, especially if routine tests are normal, it's crucial to discuss the possibility of less common causes with your doctor. This case demonstrates that considering rare conditions can lead to accurate diagnosis and effective treatment, ultimately improving patient outcomes.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1080/ac.69.3.3027841, Alternate LINK

Title: Large Bronchogenic Cyst Compressing The Left Atrium

Subject: Cardiology and Cardiovascular Medicine

Journal: Acta Cardiologica

Publisher: Informa UK Limited

Authors: Theodoros Routoulas, Georgios Triantis, Nikolaos Smigadis, Panagiota Mylona, Dimitrios Sionis

Published: 2014-06-01

Everything You Need To Know

What exactly is a bronchogenic cyst?

A bronchogenic cyst is an uncommon growth, specifically a mediastinal tumor, that develops in the chest, often in the area between the lungs. While many remain unnoticed, some can lead to breathing problems, chest pain, or recurrent chest infections. In rare instances, like the one discussed, they can cause significant issues by impacting other organs.

How did the bronchogenic cyst specifically cause breathing problems in the 48-year-old patient?

In the case presented, the location of the bronchogenic cyst—behind the left atrium of the heart—caused it to compress the heart. This compression deformed the shape of the left atrium, leading to impaired left ventricular diastolic function and ultimately causing the patient to experience progressive breathing difficulty.

What was the treatment for the bronchogenic cyst, and what were the outcomes?

The primary treatment for a symptomatic bronchogenic cyst, especially one causing compression, is surgical removal. In the case described, surgical removal of the bronchogenic cyst successfully alleviated the pressure on the heart. The removal helped restore normal heart function and resolve the patient's breathing difficulties. The pathology report confirmed that the cyst was not cancerous, leading to a positive outcome for the patient.

Besides affecting the heart, what other respiratory issues can bronchogenic cysts cause?

While the report focused on a bronchogenic cyst's impact on the heart, these cysts can also cause other respiratory issues. The compression of the lungs or airways could lead to symptoms like persistent coughing, wheezing, or shortness of breath. Additionally, recurrent chest infections can occur if the cyst obstructs normal lung function or drainage.

What's the key takeaway regarding the diagnosis and treatment of unusual breathing difficulties, based on this case of the bronchogenic cyst?

The case underscores the importance of considering unusual causes when diagnosing breathing difficulties. Even when routine tests return normal results, further investigation, such as echocardiograms or cardiac MRIs, may be necessary to identify rare conditions like a bronchogenic cyst. The successful treatment highlights that addressing the underlying cause can lead to significant improvements in a patient's health and quality of life.