Case report on the radiographic features of epipericardial fat necrosis in a patient presenting with acute chest pain.

Autor: Kenyon SK; Department of Medical Imaging, The Prince Charles Hospital, Brisbane, Queensland, Australia., Wijesekera VA; University of Queensland, Brisbane, Queensland, Australia.; Department of Cardiology, The Prince Charles Hospital, Brisbane, Queensland, Australia., Wesley AJ; Department of Medical Imaging, The Prince Charles Hospital, Brisbane, Queensland, Australia.; University of Queensland, Brisbane, Queensland, Australia.
Jazyk: angličtina
Zdroj: Journal of medical imaging and radiation oncology [J Med Imaging Radiat Oncol] 2023 Aug; Vol. 67 (5), pp. 509-513. Date of Electronic Publication: 2023 Jul 16.
DOI: 10.1111/1754-9485.13562
Abstrakt: Epipericardial fat necrosis (EFN) is a rare and benign condition. The three cardinal features of EFN are acute pleuritic chest pain, radiological features of an encapsulated fatty lesion within the epipericardial fat and the presence of inflammation within the surrounding pericardium. The exact aetiology is still unknown, and there are no known risk factors. The condition appears to be a transient process with no associated long-term complications. In this case study, we demonstrate the multitude of radiological features associated with this condition. A 29-year-old Caucasian female presented with acute pleuritic chest pain. There were no acute changes on her blood work, electrocardiogram (ECG) or echocardiogram. The chest radiograph showed an opacity projected within the anterior mediastinum. Further imaging, with computed tomography (CT) chest with contrast, was performed to define the characteristics of the opacity. This confirmed an encapsulated, mixed fat, soft tissue density in the left pericardiac region deemed to represent EFN. Follow-up magnetic resonance (MR) cardiac imaging at 1, 4 and 12 months demonstrated the self-resolving characteristics of this condition. EFN is a rare differential diagnosis to consider in patients presenting with acute pleuritic chest pain when laboratory tests are normal and there are no acute ECG findings. EFN should be excluded by imaging with CT or MRI of the heart. We have demonstrated through follow-up MR imaging the progression and resolution of EFN over 12 months.
(© 2023 The Royal Australian and New Zealand College of Radiologists.)
Databáze: MEDLINE
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