A 52-year-old woman was seen with atypical chest pain. A routine chest
roentgenogram revealed an enlarged cardiac silhouette. Results of tra
nsthoracic echocardiography performed using the standard views was nor
mal. Because of the discrepancy between the findings of chest roentgen
ogram and transthoracic echocardiography, a biplane transesophageal ec
hocardiogram was obtained and revealed the presence of a pericardial c
yst.