Epipericardial fat necrosis
KeywordsEpipericardial fat necrosis, chest pain, mediastinal tumour
Introduction: Epipericardial fat necrosis (EFN) is a relatively rare benign disease that causes acute chest pain.
Case Description: A woman in her 20s presented with acute left shoulder and epigastric pain. One day before presentation, she had visited a cardiologist and an acute coronary syndrome had been ruled out. The pain worsened with deep inspiration. Chest computed tomography (CT) showed a soft-tissue attenuation lesion containing a fatty centre located in the epipericardial fat at the left cardiophrenic angle. Hence, EFN was diagnosed and the pain was resolved with loxoprofen. The lesion had disappeared on a follow-up chest CT scan.
Discussion: EFN is a rare benign disease that causes acute chest pain. Approximately 70–90% of EFN cases are misdiagnosed by clinicians as other diseases.
Conclusion: In patients with acute chest pain, the correct diagnosis of EFN avoids unnecessary invasive investigations and reassures patients.
Issue: 2023: Vol 10 No 3 (view)