A Case Report of Congenitally Absent Pericardium Masquerading as Recurrent Pericarditis.

Autor:	Sempokuya T; Division of Cardiology, Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI., Lum CJ; Division of Cardiology, Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI., Veillet-Chowdhury M; Division of Cardiology, Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI., Rivera K; Division of Cardiology, Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI.
Jazyk:	angličtina
Zdroj:	Hawai'i journal of medicine & public health : a journal of Asia Pacific Medicine & Public Health [Hawaii J Med Public Health] 2019 Apr; Vol. 78 (4), pp. 137-140.
Abstrakt:	A 24-year-old female with a history of Swyer-James-MacLeod syndrome presented with acute onset of pleuritic chest pain and was initially diagnosed with acute pericarditis. The 12-lead electrocardiogram demonstrated typical diffuse ST-segment elevation and PR-segment depression. Symptoms resolved rapidly with anti-inflammatory therapy consisting of ibuprofen and colchicine. After completing a 3-month course of the latter, her symptoms rapidly recurred. Workup, including labs and cardiac imaging consisting of a transthoracic echocardiogram and cardiac magnetic resonance imaging, was initially interpreted as normal. Re-review of her cardiac imaging revealed the patient had signs of a congenitally absent pericardium, including a "Snoopy Sign" on her posterior-anterior chest X-ray, which is characterized by levoposition of the cardiac silhouette, a lucent area between the pulmonary artery and aorta because of the presence of lung tissue, a lucent area between the base of the heart and the left hemidiaphragm, loss of the right heart border, a prominent pulmonary artery, and a flattened and elongated left ventricular contour. The patient had a cardiac computed tomography scan, which confirmed the diagnosis. In conclusion, a congenitally absent pericardium is a rare disorder, often undetected or misdiagnosed. There are characteristic findings on imaging such as a "Snoopy Sign" on a posterior-anterior chest X-ray, which can be easily missed because of its rarity. Our goal of this report is to educate health care providers about this rare disorder. Competing Interests: This case report was approved by Institutional Review Board of Queens Medical Center for publication. Informed consent could not be obtained due to loss of follow up after resolution of symptoms. There is no identifiable data in this case report. All of authors do not have any disclosure or conflict of interest.
Databáze:	MEDLINE
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