A Rare Cause of Dyspnea: Pericardial Epiploic Appendigitis

Epipericardial Fat Necrosis: A Case Report and a Review of the Literature

“…No age predilection is known to exist, but the typical patient has so far been characterized as middle-aged with presentation at 43 to 50 years. 3 , 4 , 11 , 14 , 16 The latest articles in our search (2016-2019) reported in sum slightly younger patients 2 , 9 , 10 , 22 , 23 , 25 , 26 , 28 , 29 resulting in a mean age of 39.4 years. Lately, reports of EFN in the paediatric population have also emerged.…”

“… 3 , 9 Most patients are pain free within the first week 1 , 14 , 17 , 21 and serial CT has shown partial or full resolution after 2 to 12 weeks. 8 , 9 , 11 , 22 , 23 Relapses are sometimes seen, 17 , 19 , 21 , 22 but reports of these are rare and prognosis is usually very good. Surgery may still be indicated in rare cases if diagnostic uncertainties remain or for treatment of persisting, intractable pain.…”

“…In the few cases performed, TTE in EFN are reported as normal, despite a positive chest CT. 3 , 6 , 9 , 10 , 22 It has been suggested that failure to identify the epipericardial fat pad necrosis in EFN might be due to lung artefacts or the patient being unable to position himself optimally for the examination due to pain. 6 An exception was a report where both transthoracic and transoesophageal echocardiography revealed a paracardiac mass with a calcified rim, suggestive of chronic EFN.…”