Left-side pericardial agenesis: Putting the pieces together

Area of Science:

• Cardiology
• Radiology
• Medical Imaging

Background:

• Pericardial agenesis is a rare congenital anomaly.
• Left-sided agenesis is particularly uncommon and can present with nonspecific symptoms.

Observation:

• A 56-year-old woman presented with atypical chest pain.
• Initial imaging (chest radiograph, echocardiogram) suggested pericardial agenesis.
• Cardiac computed tomography revealed extreme cardiac levoposition and lung interposition.

Findings:

• Multimodality imaging, including cardiac CT and MRI, confirmed left-side pericardial agenesis.
• The findings demonstrated a unique anatomical variation due to the absence of the left pericardium.

Implications:

• An integrated imaging approach is valuable for diagnosing rare conditions like pericardial agenesis.
• Early and accurate diagnosis facilitates a conservative management strategy.
• Understanding this anomaly is crucial for differentiating it from other causes of chest pain.