[Total congenital absence of left pericardium in 3 cases]

Area of Science:

• Cardiology
• Radiology
• Anatomy

Background:

• Congenital absence of the left pericardium is an exceptionally rare condition.
• This case series reports on three adult women diagnosed with this anomaly.

Observation:

• Patients presented with atypical chest pain or radiologic cardiomegaly of unknown origin.
• Physical examination revealed a left-displaced cardiac apex.
• Electrocardiogram showed right axis deviation, incomplete right bundle branch block, and clockwise rotation.

Findings:

• Chest X-rays demonstrated a left-displaced heart, prominent pulmonary artery, and characteristic 'pulmonary flap'.
• Echocardiography suggested left chamber enlargement and required specific transducer positioning for visualization.
• Computed tomography and magnetic resonance imaging confirmed the diagnosis.

Implications:

• This rare condition should be considered in the differential diagnosis of atypical chest pain and unexplained cardiomegaly.
• Multimodality imaging is crucial for accurate diagnosis and characterization.
• Understanding the imaging findings is essential for appropriate patient management.