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Case Reports
. 2021 Jan-Mar;14(1):119-121.
doi: 10.4103/apc.APC_152_19. Epub 2020 Sep 23.

Pericardial agenesis

Paula Concejo Iglesias  1 , Elisa Aguirre Pascual  2 , Leticia Albert de la Torre  3 , David Coca Robinot  2 , Belén Toral Vázquez  3 , Miguel A Granados Ruiz  3
Affiliations
Case Reports

Pericardial agenesis

Paula Concejo Iglesias et al. Ann Pediatr Cardiol. 2021 Jan-Mar.

Abstract

Congenital pericardial defect is a rare and usually asymptomatic condition which is classified incomplete or partial. Up to 70% of cases consist of complete absence of left pericardium. The diagnosis may be challenging due to its low frequency and absence of correlation with any specific finding on the clinical examination. Cardiac magnetic resonance imaging is the gold standard imaging technique for the diagnosis confirming the absence of pericardium, although other indirect signs may be seen. In partial defects, surgery is the treatment option. We present an incidental finding of total agenesis of the left pericardium in an asymptomatic 16-year-old male diagnosed in a preoperative assessment of a bone fracture.

Keywords: Magnetic resonance imaging; pediatrics; pericardial disease.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Electrocardiogram: sinus rhythm at 90 bpm with axis deviation to the right, absence of R-wave growth in precordial, and growth data of right cavities. In addition, the presence of the phenomenon of swinging heart in right precordial
Figure 2
Figure 2
Posteroanterior chest X-ray: Morphologic alteration of the cardiac silhouette and levo position of the heart with an overlap of the right cardiac border to the vertebral column (black arrows), increase of the aortic knob, and of the main pulmonary artery convexity with interposition of lung tissue between them (*), and a band of lucency between the heart and left hemidiaphragm is also seen (white arrow)
Figure 3
Figure 3
(a and b) Cardiac magnetic resonance imaging short-axis view on steady-state free precession-weighted image: The portion of the posterior wall of the left ventricle (between arrows) is presumed to be the pericardial defect. The pericardium is seen as a low-intensity linear band (arrowheads). (c) Axial fast imaging employing steady-state acquisition magnetic resonance imaging showing the interposition of lung tissue between the aorta and pulmonary artery (arrow). (d) Four-chamber view on a steady-state free precession-weighted sequence: Marked leftward shift of the heart into left hemithorax, note the apex pointing posteriorly
See this image and copyright information in PMC

References

    1. Cuccuini M, Lisi F, Consoli A, Mancini S, Bellino V, Galanti G, et al. Congenital defects of pericardium: Case reports and review of literature. Ital J Anat Embryol. 2013;118:136–50. - PubMed
    1. Shah AB, Kronzon I. Congenital defects of the pericardium: A review. Eur Heart J Cardiovasc Imaging. 2015;16:821–7. - PubMed

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