Case Report
Copyright ©2013 Baishideng. All rights reserved.
World J Cardiol. Feb 26, 2013; 5(2): 12-14
Published online Feb 26, 2013. doi: 10.4330/wjc.v5.i2.12
Congenital partial absence of the pericardium in a young man with atypical chest pain
Alan Luis Juárez, Finn Akerström, Ana-María Alguacil, Belén Santos González
Alan Luis Juárez, Ana-María Alguacil, Department of Internal Medicine, Virgen de la Salud Hospital, 45004 Toledo, Spain
Finn Akerström, Belén Santos González, Department of Cardiology, Virgen de la Salud Hospital, 45004 Toledo, Spain
Author contributions: Juárez AL and Akerström F wrote the majority of the manuscript; Alguacil AM and González BS provided expert opinion on patient management and cardiac imaging, respectively.
Correspondence to: Dr. Alan Luis Juárez, MD, Department of Neurology, Complejo Hospitalario de Toledo, Av. Barber 30, 45004 Toledo, Spain. aljuarezb@sescam.jccm.es
Telephone: +34-925-269134 Fax: +34-925-269149
Received: October 17, 2012
Revised: February 7, 2013
Accepted: February 8, 2013
Published online: February 26, 2013
Processing time: 156 Days and 14.8 Hours
Abstract

Pericardial defects are infrequent congenital anomalies due to agenesis caused by premature atrophy of the common cardinal vein or Cuvier duct during the 5th or 6th week of embryonic life. These congenital defects are rare, typically observed as an incidental finding and usually remain asymptomatic. Nevertheless, the more widespread use of modern imaging techniques has contributed to an increase of its incidence in recent years. There is currently no consensus regarding therapeutic options, all of which are based on small retrospective studies that evaluate the risk of developing a life-threatening complication such as herniation and incarceration of the myocardium. We report on a 22-year-old male who presented with sudden onset of sharp chest pain and dyspnea. Computed tomography and cardiac magnetic resonance scan revealed a pericardial defect adjacent to the lateral free wall of the left atrium with associated herniation of the left atrial appendage. The patient was managed conservatively and had an uneventful clinical progress.

Keywords: Pericardial defect, Chest pain, Atrial herniation