Congenital complete absence of the left pericardium: a rare cause of chest pain or pseudo-right heart overload.
BACKGROUND
Congenital defects of the pericardium are rare and poorly known cardiac malformations. Most of them are left-sided and asymptomatic and are usually incidentally diagnosed.


OBJECTIVE
To describe the clinical, electrocardiographic, and imaging features of total absence of the left pericardium.


RESULTS
We report the cases of 3 patients who have been seen in our institution with a diagnosis of total congenital absence of the pericardium. All of them complained of precordial pain; one of them experienced disabling symptoms that justified surgical intervention. All of them had previously been suspected to have an atrial septal defect because of the echocardiographic appearance of right ventricular volume overload. Electrocardiogram, chest x-ray, echocardiography, and magnetic resonance imaging of the heart consistently showed remarkably similar features including leftward displacement, increased mobility, and interposition of lung tissue between the heart and other intrathoracic structures.


CONCLUSIONS
Congenital absence of the left pericardium should be known by clinicians as a possible differential diagnosis of chest pain or pseudo-right heart overload.
Garnier
Fabien
F
Centre de Cardiologie Clinique et Interventionnelle, Hôpital du Bocage, Centre Hospitalo-Universitaire de Dijon, Dijon, France.
Eicher
Jean-Christophe
JC
Philip
Jean-Luc
JL
Lalande
Alain
A
Bieber
Hubert
H
Voute
Marie-France
MF
Brenot
Roger
R
Brunotte
François
F
Wolf
Jean-Eric
JE
D000328:Adult; D006348:Cardiac Surgical Procedures; D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome