Key result
Multi-modality imaging, particularly cardiac MRI, successfully identified left pericardial agenesis in a 32-year-old male presenting with atypical chest pain mimicking myocardial infarction.
Why the study?
Congenital pericardial absence is an uncommon cardiac anomaly that is commonly misdiagnosed, but it should be considered in the differential diagnosis of chest pain.
Case Report (n=1)
No
Multi-modality imaging, particularly cardiac MRI, is crucial for diagnosing the rare congenital anomaly of pericardial agenesis in young patients presenting with atypical chest pain.
Pericardial agenesis warrants consideration in chest pain differentials; this Level 5 case leaves open prospective validation of multi-modality imaging.
BACKGROUND: Congenital pericardial absence is an uncommon cardiac anomaly that is typically asymptomatic and commonly misdiagnosed due to a lack of symptoms or atypical symptoms. Pericardial agenesis (PA) should be considered one of the differential diagnoses when the patient presents with chest pain. This case shows how the diagnosis of pericardial agenesis is made exclusively using multi-modality imaging, starting from findings in a basic chest radiograph to cardiac MRI, while also demonstrating the classic signs seen in this condition. Magnetic resonance imaging of the heart is the gold standard for determining the absence of pericardium in the prognosis. CASE PRESENTATION: A 32-year-old male who presented with chest discomfort and radiating pain to his back and left shoulder mimicking myocardial infarction with normal ECG and enzyme markers. A chest radiograph (taken 24 h apart) demonstrates the left lateral position of the heart and the bulging contour of the left heart border, a lucent area between the aorta and pulmonary artery. Subsequently, cardiac MRI reveals left pericardial agenesis. CONCLUSIONS: This article provides insight into a rare differential to consider in a young patient presenting with chest discomfort. This case shows how the diagnosis of pericardial agenesis is made exclusively using multi-modality imaging, starting from findings in a basic chest radiograph to cardiac MRI, while also demonstrating the classic signs seen in this condition.
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Kalekar et al. (2023) conducted a case report in Pericardial agenesis (n=1). Multi-modality imaging (Cardiac MRI, Chest X-ray, Echocardiography) was evaluated on Diagnosis of pericardial agenesis. Multi-modality imaging, particularly cardiac MRI, successfully identified left pericardial agenesis in a 32-year-old male presenting with atypical chest pain mimicking myocardial infarction.
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