DOI: 10.12890/2023_003823
Epipericardial fat necrosis
Authors
hh06m1014@yahoo.co.jp
Keywords
Epipericardial fat necrosis, chest pain, mediastinal tumourAbstract
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.
References
- Jackson RC, Clagett OT, Mcdonald JR. Pericardial fat necrosis; report of three cases. J Thorac Surg 1957;33:723–729.
- Zafar MR, Mustafa SF, Shahbaz A, Warraich S, Altaf A. Epipericardial fat necrosis: a concise review of literature. Cureus 2021;13:e13106.
- de Souza Giassi K, Costa AN, Bachion GH, Kairalla RA, Filho JRP. Epipericardial fat necrosis: who should be a candidate? AJR Am J Roentgenol 2016;207:773–777.
- Kumei S, Ishitoya S, Oya A, Ohhira M, Ishioh M, Okumura T. Epipericardial fat necrosis: a retrospective analysis in Japan. Intern Med 2022;61:2427–2430.