Key result
Congenital absence of the left pericardium was diagnosed in a 56-year-old male presenting with non-specific cardiac symptoms, highlighting the need to consider this rare condition when imaging suggests heart rotation and large range of motion.
Why the study?
Congenital absence of the pericardium is rare, symptoms vary, and most doctors lack knowledge of the condition, with most cases being incidental findings.
Case Report (n=1)
No
Congenital absence of the pericardium should be considered in the differential diagnosis when imaging suggests heart rotation and a large moving range of the heart in the thoracic cavity.
Partial CAP may present with nonspecific symptoms; extends sparse case reports but leaves management questions open.
BACKGROUND: Congenital absence of the pericardium (CAP) is rare in clinical practice, the symptoms vary among patients, and most doctors do not have enough knowledge of the condition. Most reported CAP cases are incidental findings. Therefore, this case report aimed to present a rare case of left partial CAP that presented with non-specific, possibly cardiac-related symptoms. CASE PRESENTATION: The patient, male, 56 years old, Asian, was admitted on March 2, 2021. The patient complained of occasional dizziness in the past week. The patient was suffering from hyperlipidemia and hypertension (stage 2), both untreated. The patient reported chest pain, palpitations, discomfort in the precordium, and dyspnea in the lateral recumbent position after strenuous activities, all of which started when he was about 15 years old. ECG showed sinus rhythm, 76 bpm, premature ventricular beats, incomplete right bundle branch block, and clockwise rotation of the electrical axis. Most of the ascending aorta could be detected in the parasternal intercostal space 2-4 by transthoracic echocardiography in the left lateral position. Chest computed tomography revealed the absence of pericardium between the aorta and the pulmonary artery, and part of the left lung was extending into the space. No changes in his condition have been reported up to now (March 2023). CONCLUSIONS: CAP should be considered when multiple examinations suggest heart rotation and a large moving range of the heart in the thoracic cavity.
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Li et al. (2023) conducted a case report in Congenital absence of the left pericardium (n=1). Congenital absence of the left pericardium was evaluated. Congenital absence of the left pericardium was diagnosed in a 56-year-old male presenting with non-specific cardiac symptoms, highlighting the need to consider this rare condition when imaging suggests heart rotation and large range of motion.
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