The patient was later placed on anticoagulation for treatment of the thrombus with follow-up scheduled in 3 months time to assess for resolution.

Pericardial agenesis is caused by defective development of the pleuropericardial membranes. Congenital pericardial agenesis is usually asymptomatic and discovered incidentally. Patients may present with a right bundle branch block on EKG, poor R wave progression, and prominent P waves. Complete pericardial agenesis has the best prognosis whereas partial agenesis may leave opportunity for herniation of tissues. Intervention should only be considered if complications of the defect are present.

This case was submitted with supervision and input from:

M. Attrach, M.D.
Cardiovascular Radiologist
Erasmus Medical Center
Rotterdam, The Netherlands