Epipericardial fat necrosis

Yumi Otaka; Yukinori Harada; Ren Kawamura; Taro Shimizu

doi:10.12890/2023_003823

Epipericardial fat necrosis

Yumi Otaka Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Mibu, Tochigi, Japan
Yukinori Harada Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Mibu, Tochigi, Japan
Ren Kawamura Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Mibu, Tochigi, Japan
Taro Shimizu Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Mibu, Tochigi, Japan

DOI: https://doi.org/10.12890/2023_003823

Keywords

Epipericardial fat necrosis, chest pain, mediastinal tumour

Abstract

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.

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