Pericardial fat necrosis

Case contributed by Dr Sajith Karunasena


Two week history of left-sided pleuritic chest pain. On oral contraceptive pill. Elevated D-dimer. CTPA requested to exclude pulmonary embolism.

Patient Data

Age: 55 years
Gender: Female

Pericardial fat necrosis

No pulmonary embolism identified in a good quality CT pulmonary angiogram. 

An encapsulated ovoid fat-density lesion measuring 29 x 15 mm is seen within the left anterior pericardial fat, with surround inflammatory stranding. There is also a small left pleural effusion.

Case Discussion

Findings are consistent with pericardial fat necrosis. Small pleural effusion is present, which is a common associated feature. This rare, self-limiting condition symptomatically mimics pulmonary embolism, hence is often identified on CT pulmonary angiogram. 

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Case information

rID: 77712
Published: 20th May 2020
Last edited: 21st May 2020
System: Cardiac, Chest
Inclusion in quiz mode: Included

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