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

Mortensen, Synnøve Gjelsten; P, Buchmann; Lappegård, Knut Tore

doi:10.1177/1179547620940769

Cited by 9 publications

(22 citation statements)

References 30 publications

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“…The values of laboratory tests are usually normal, but increases in the levels of D-dimer, CRP and/or WBC count are often found in EFN patients (7), as was seen in our patients. ECG findings are also usually normal, but nonspecific ST-T wave changes have been reported (3), as were found in Patient 5 in our study.…”

Section: Discussionsupporting

confidence: 77%

Epipericardial Fat Necrosis: A Retrospective Analysis in Japan

et al. 2022

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Objective Epipericardial fat necrosis (EFN) has been considered to be a rare cause of acute chest pain, and especially important for emergency physicians. Chest computed tomography (CT) is often used for the diagnosis of EFN after excluding life-threatening states, such as acute coronary syndrome and pulmonary embolism. While the proportion of EFN patients who underwent chest CT in emergency departments is being clarified, little is still known about other departments in Japan. To investigate the proportion of EFN patients who underwent chest CT for acute chest pain in various departments. Methods Chest CT performed from January 2015 to July 2020 in Asahikawa Medical University Hospital in Japan was retrospectively analyzed in this study. All images were reviewed by two radiologists. Results There were 373 outpatients identified by a search using the word 'chest pain' who underwent chest CT. Eight patients satisfying the imaging criteria were diagnosed with EFN. The proportions of patients diagnosed with EFN were 10.7%, 4.8%, 2.8%, 0.9% and 0% in the departments of general medicine, cardiovascular surgery, emergency medicine, cardiovascular internal medicine and respiratory medicine, respectively. Only 12.5% of the patients were correctly diagnosed with EFN, and the other patients were treated for musculoskeletal symptoms, acute pericarditis or hypochondriasis. Conclusion EFN is not rare and is often overlooked in various departments. All physicians as well as emergency physicians should consider the possibility of EFN as the cause of pleuritic chest pain.

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Section: Discussionsupporting

confidence: 77%

Epipericardial Fat Necrosis: A Retrospective Analysis in Japan

et al. 2022

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“…EFN typically presents as sudden onset pleuritic chest pain radiating to the shoulder, usually on the left 3 4. There may be accompanying dyspnoea 4.…”

Section: Answersmentioning

confidence: 99%

“…EFN typically presents as sudden onset pleuritic chest pain radiating to the shoulder, usually on the left 3 4. There may be accompanying dyspnoea 4. It can be difficult to distinguish EFN from pulmonary embolism, and workup is usually directed towards excluding the latter.…”

Section: Answersmentioning

confidence: 99%

“…EFN aetiology remains unknown 4. It may result from torsion of the tissue, or from localised haemorrhage caused by valsalva 3 4…”

Section: Answersmentioning

confidence: 99%

“…Historically, EFN treatment was surgical, but the majority of the literature now suggests that the condition is usually self-limiting, settling within days of non-steroidal treatment 3–5…”

Section: Answersmentioning

confidence: 99%

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