Epipericardial fat necrosis: an unusual cause of chest pain

Epipericardial fat necrosis: Uncommon cause of acute pleuritic chest pain

“…Additional likely predisposing factors include pre-existing structural abnormality making adipose tissue vulnerable to trauma and acute torsion of a vascular pedicle of adipose tissue triggering fat necrosis. It has also been proposed that increased capillary pressure during Valsalva maneuver may cause microvascular bleed into the adipose tissue initiating hemorrhagic fat necrosis [3] .…”

“…When performed, however, the pathologic features closely resemble epiploic appendagitis with a central focus of necrotic adipose cells encompassed by macrophages and neutrophils. Specimens obtained later in the clinical course will show fibrosis as the lesion has resolved into a scar tissue [3] , [9] .…”

Epipericardial fat necrosis: an underdiagnosed condition

“…11 However, after a few EFN cases were diagnosed in our institution, 10 we hypothesized that this condition could be overlooked, or even misdiagnosed, by emergency physicians and radiologists.…”

“…6,7 Patients usually present to the emergency department (ED) with an acute chest pain, lasting from a few hours to a couple of days. [8][9][10] The physical examination is often unremarkable, but an increased heart rate and diaphoresis may be found. Previously published case reports and reviews also demonstrate normal electrocardiograms and blood tests, as well as normal cardiac enzyme levels and negative Coxsackie viral panels.…”

Epipericardial Fat Necrosis. An Important Differential Diagnosis of Chest Pain

“…[1][2][3][4][5][6][7][8][9] The pathophysiology of the disease remains uncertain. Likely predisposing factors include torsion of the vascular pedicle of adipose tissue, structural alterations that make the tissue more vulnerable and obesity, which, like the Valsalva maneuver, can lead to increased capillary pressure, causing hemorrhage into the adipose tissue.…”