Pericardial fat pads
Last revised by Mohammadtaghi Niknejad ◉ on 8 Apr 2022
Citation, DOI, disclosures and article data
Citation:
Knipe H, Niknejad M, Gamage P, et al. Pericardial fat pads. Reference article, Radiopaedia.org (Accessed on 08 Jun 2023) https://doi.org/10.53347/rID-38494
rID:
38494
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Disclosures:
At the time the article was created Henry Knipe had no recorded disclosures.
View Henry Knipe's current disclosuresLast revised:
8 Apr 2022, Mohammadtaghi Niknejad ◉
Disclosures:
At the time the article was last revised Mohammadtaghi Niknejad had no recorded disclosures.
View Mohammadtaghi Niknejad's current disclosuresRevisions:
13 times, by 9 contributors - see full revision history and disclosures
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Synonyms:
- Pericardial fat pad
- Pericardial fat pads
Pericardial fat pads are normal structures that lie in the cardiophrenic angle. They are adipose tissues surrounding the heart composed of the epicardial fat, which lies between the myocardium and visceral pericardium, and paracardial fat, which is adherent and external to the parietal pericardium. Unsurprisingly, they are more prominent in obese patients.
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Pathology
They can be affected by fat necrosis, see: pericardial fat necrosis and inflammation directly causing coronary athetomatous disease 6.
Radiographic features
Plain radiograph
- mass or hazy opacity in the cardiophrenic angle
- cardiac and diaphragmatic silhouettes usually visible
CT
- easily differentiates pericardial fat pad from pathology other than a lipoma
Differential diagnosis
At times they are large enough to simulate pathology and can be mistaken for:
- lipoma or another pericardial tumor
- pericardial cyst (especially on the right)
- Morgagni hernia
- epicardial lymphadenopathy
- pleural tumor
- pseudocardiomegaly
Quiz questions
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References
- 1. McLoud TC. Thoracic Radiology: The Requisites: The Requisites (Requisites in Radiology). Mosby. ISBN:B005DXPW0W. Read it at Google Books - Find it at Amazon
- 2. Pope TL. Harris & Harris' Radiology of Emergency Medicine. Lippincott Williams & Wilkins. (2012) ISBN:145110720X. Read it at Google Books - Find it at Amazon
- 3. Grant, Griffin. Grainger & Allison's Diagnostic Radiology Essentials. Churchill Livingstone. ISBN:B00CC6IA3Y. Read it at Google Books - Find it at Amazon
- 4. Wong CX, Ganesan AN, Selvanayagam JB. Epicardial fat and atrial fibrillation: current evidence, potential mechanisms, clinical implications, and future directions. (2017) European heart journal. 38 (17): 1294-1302. doi:10.1093/eurheartj/ehw045 - Pubmed
- 5. Stephan MS, Stephan RW, Stephan LL, Stephan CL, Stephan PEOB, Stephan AJT. Effects of Weight Loss on Pericardial Fat and Left Ventricular Mass Assessed with Cardiac Magnetic Resonance Imaging in Morbid Obesity. (2011) doi:10.4236/ijcm.2011.24062
- 6. Bertaso AG, Bertol D, Duncan BB, Foppa M. Epicardial fat: definition, measurements and systematic review of main outcomes. (2013) Arquivos brasileiros de cardiologia. 101 (1): e18-28. doi:10.5935/abc.20130138 - Pubmed
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