Congenital pericardial defect diagnosed by computed tomography

Abstract

Complete or partial absence of the pericardium is a relatively rare disorder. While physical examination, electrocardiogram, and chest x-ray may suggest the diagnosis, definitive noninvasive diagnosis has until recently not been possible. In the patient described in the present report, the basis for chest pain initially attributed to myocardial ischemia was established noninvasively by computed tomographic examination of the chest to be congenital absence of the left pericardium. Experience with this patient emphasizes the fact that one of the known bases for nonischemic chest pain--congenital pericardial defects--can be precisely defined by contrast-negative computed tomographic imaging.

Congenital absence of the pericardium: case presentation and review of literature

“…However, symptomatic patients may experience non-exertional paroxysmal stabbing chest pain [2]. Electrocardiography (ECG), plain chest X-ray (CXR), echocardiography (echo) [1], CT scan [3], and magnetic resonance imaging (MRI) may aid in the diagnosis [4].…”

Heart luxation through a right-sided traumatic pericardial defect

“…Occasionally, this developmental condition may induce symptoms and complications such as pain, syncopes, coronary artery disease, and sudden death [11]. The differential diagnosis between a congenital or traumatic lesion relates to the position of the phrenic nerve to the pericardial defect.…”

“…Both CT and MRI are valuable noninvasive techniques in portraying pericardial defects. To induce an artificial pneumothorax is not required anymore to prove the communication with the pericardial sac [11,13].…”

Partial Right-Sided Congenital Pericardial Defect

“…Perikardiyal defektler sıklıkla asemptomatik seyrettikleri için tanılarının konması zordur. MRI ve BT gibi tanısal yöntemler faydalıdır, ancak her zaman yeterli değildir (6,7) . Semptomsuz hastalar sıklıkla başka bir sebepten dolayı uygulanan kardiyak veya toraks ameliyatları esnasında saptanırlar.…”