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Epipericardial fat necrosis: an underdiagnosed condition
K de S Giassi1, A N Costa, G H Bachion
1Radiology Division, Hospital Sírio-Libanês, São Paulo, Brazil.
The British Journal of Radiology
|April 9, 2014
Summary
Epipericardial fat necrosis (EFN) is a rare cause of chest pain often missed in the emergency department. This study highlights its clinical and radiological features to aid diagnosis and avoid unnecessary tests.
Area of Science:
- Radiology
- Emergency Medicine
- Pathology
Background:
- Epipericardial fat necrosis (EFN) is an uncommon, benign condition presenting as acute pleuritic chest pain.
- Patients with EFN often seek emergency department (ED) care due to severe chest pain.
Purpose of the Study:
- To describe EFN cases encountered at our institution.
- To illustrate the clinical and radiological findings associated with EFN.
Main Methods:
- Retrospective review of 3604 chest scans from the ED.
- Analysis of medical records and CT reports for patients diagnosed with epipericardial necrosis.
Main Results:
- 11 patients had definitive EFN findings: a round, soft-tissue lesion with strands.
- All patients experienced pleuritic chest pain ipsilateral to the lesion.
- Associated findings included pericardial thickening, pleural effusion, and atelectasis; cardiac enzymes and D-dimer were normal.
- Only 27% of EFN cases were correctly diagnosed initially.
Conclusions:
- EFN is a benign inflammatory condition often overlooked in the ED.
- EFN is crucial in the differential diagnosis of acute chest pain.
- Accurate diagnosis of EFN can prevent unnecessary investigations.
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