Pericardial fat necrosis: a review and update

Area of Science:

• Cardiology
• Radiology
• Thoracic Surgery

Background:

• Sudden onset of severe chest pain can indicate various critical conditions.
• Initial diagnostic workup may not immediately identify the underlying cause.
• Delayed diagnosis of thoracic masses can lead to poor outcomes.

Purpose of the Study:

• To present a case of a patient with acute chest pain and a subsequently discovered cardiac mass.
• To emphasize the diagnostic value of serial imaging in unexplained thoracic symptoms.

Main Methods:

• Clinical presentation of a middle-aged patient with acute, severe chest pain.
• Initial diagnostic evaluation including physical examination, electrocardiogram, blood studies, and chest radiograph.
• Follow-up chest radiography performed three days later.

Main Results:

• Patient presented with excruciating left-sided chest pain, tachycardia, and tachypnea.
• Initial electrocardiogram, blood work, and chest radiograph were unremarkable.
• A 3.5 x 4-cm mass adjacent to the left side of the heart was identified on follow-up imaging.

Conclusions:

• A cardiac mass should be considered in the differential diagnosis of acute chest pain, even with initially normal investigations.
• Serial chest radiography can be crucial for diagnosing slowly evolving or initially occult thoracic pathologies.
• Prompt identification and management of cardiac masses are essential for patient prognosis.