A 16-year-old male was investigated for exercise-induced dyspnea and paroxysmal palpitations. There was no prominent right heart border in a chest radiograph. A congenital intrapericardial right atrial aneurysm was diagnosed from 2-dimensional echocardiographic findings of a large echo-free space close to the right atrium, and confirmed by magnetic resonance imaging and surgical pathology. Successful repair was achieved on a beating heart with a brief period of on-pump support. Postoperatively, the symptoms disappeared completely.
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