Epipericardial Fat Necrosis

Abstract

Epipericardial fat necrosis is a rare cause of chest pain. It presents as pleuritic pain in an otherwise healthy patient. Computed tomography has proved to be the most effective diagnostic imaging technique because of its ability to reveal typical alterations in the cardiophrenic space. As far as we know, sonographic findings concerning this entity have not been reported in the literature. We report 4 cases admitted to our institutional emergency department with chest pain. Among other tests, chest wall sonography was requested in these patients and showed special findings that should be evaluated with chest computed tomography.

Epipericardial Fat Necrosis: A Concise Review of Literature

“…Diaz et al reported sonograms of four cases, which showed an ovoid mass surrounded by a hypoechoic halo. The sonographic findings in epiploic appendagitis and lipo-necrosis of subcutaneous adipose tissue are similar to those seen in EFN [28,29]. EFN may display increased uptake on gallium Ga-67 scintigraphy.…”

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

“…Chest wall sonography in the emergency setting of chest pain after ruling out myocardial infarction has been reported. 26 Here, the researchers found particular sonographic findings in 4 patients, consisting of hyperechoic nodules in the epipericardial fat surrounded by a hypoechoic halo and increased echogenicity of adjacent adipose tissue. Findings were consistent with EFN on CT and sonographically like other forms of fatty necrosis.…”

“…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.…”