DOI: 10.12890/2024_004346

Epipericardial fat necrosis and COVID-19

Authors

  • Mohsin Haseeb Department of Cardiology, University of Illinois College of Medicine, Peoria, USA
  • Abdullah Shafiq Department of Cardiology, Southern Illinois University, Illinois, USA
  • Muhammad A. Sheikh Department of Cardiology, Southern Illinois University, Illinois, USA
  • Muhammad F. Khan Department of Cardiology, Southern Illinois University, Illinois, USA

mohsinhaseeb157@gmail.com

Keywords

Epipericardial fat necrosis, chest pain, COVID-19, epipericardial adipose tissue

Abstract

Background: Epipericardial fat necrosis (EFN) is a rare and self-limiting cause of acute chest pain. We describe a case of EFN in a patient with a recent coronavirus disease (COVID-19).
Case Presentation: A 55-year-old male presented with a sudden onset of left-sided pleuritic chest pain for the past two days. The patient was diaphoretic, tachypneic, and tachycardic. Acute coronary syndrome was ruled out. A computed tomography (CT) pulmonary angiogram revealed an ovoid encapsulated fatty mass surrounded by dense appearing tissue. Patient symptoms improved remarkably with a short course of non-steroidal anti-inflammatory drugs (NSAIDs).
Discussion: EFN typically presents with a sudden onset of excruciating chest pain. Misdiagnosis, under-diagnosis, and mismanagement are unavoidable. EFN is incidentally diagnosed on CT scan. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects visceral adipose tissue and appears to increase the risk of EFN by promoting inflammatory cytokine production and death of adipocytes.
Conclusion: EFN is a rare cause of acute chest pain. SARS-CoV-2 is likely to induce EFN. This rare clinical entity should be considered in the differential of acute chest pain especially in patients with active or recent COVID-19.

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References

  1. Mortensen SG, Buchmann P, Lappegård KT. Epipericardial Fat Necrosis: A Case Report and a Review of the Literature. Clin Med Insights Case Rep 2020;13:1179547620940769.
  2. Fred HL. Pericardial fat necrosis: a review and update. Tex Heart Inst J 2010;37:82-84.
  3. You J, Hou L, Chatterjee S, Bhansali RD. Epipericardial fat necrosis: a rare, potential complication of COVID-19 pneumonia. J Am Coll Cardiol 2022;79:2370.
  4. Zayour M, Karari M, Al Ashkar R, Chammas E. Epicardial Fat Necrosis After COVID-19 Infection: A Case Report. Cureus 2022;14:e25154.
  5. Saccon TD, Mousovich-Neto F, Ludwig RG, Carregari VC, dos Anjos Souza AB, dos Passos ASC, et al. SARS-CoV-2 infects adipose tissue in a fat depot- and viral lineage-dependent manner. Nat Commun 2022;13:5722.
  6. Iacobellis G. Epicardial adipose tissue in contemporary cardiology. Nat Rev Cardiol 2022;19:593-606.
  7. Tajbakhsh A, Gheibi Hayat SM, Taghizadeh H, Akbari A, Inabadi M, Savardashtaki A, et al. COVID-19 and cardiac injury: clinical manifestations, biomarkers, mechanisms, diagnosis, treatment, and follow up. Expert Rev Anti Infect Ther 2021;19:345-357.
  8. Malavazos AE, Goldberger JJ, Iacobellis G. Does epicardial fat contribute to COVID-19 myocardial inflammation? Eur Heart J 2020;41:2333.

Published

2024-02-29

Issue

Vol. 11 No. 3 (2024)

Categories

How to Cite

1.
Haseeb M, Shafiq A, Sheikh MA, Khan MF. Epipericardial fat necrosis and COVID-19. EJCRIM [Internet]. 2024 Feb. 29 [cited 2026 Nov. 3];11(3). Available from: https://ejcrim.com/index.php/ejcrim/article/view/4346