title: Congenital partial absence of the pericardium in a young man with atypical chest pain.
abstract: Pericardial defects are infrequent congenital anomalies due to agenesis caused by premature atrophy of the common cardinal vein or Cuvier duct during the 5(th) or 6(th) 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.
authors.affiliation: Alan Luis Juárez, Ana-María Alguacil, Department of Internal Medicine, Virgen de la Salud Hospital, 45004 Toledo, Spain.
authors.forename: Alan Luis
authors.initials: AL
authors.lastname: Juárez
authors.forename: Finn
authors.initials: F
authors.lastname: Akerström
authors.forename: Ana-María
authors.initials: AM
authors.lastname: Alguacil
authors.forename: Belén Santos
authors.initials: BS
authors.lastname: González
keywords: Atrial herniation; Chest pain; Pericardial defect
references.citation: Int J Cardiol. 2005 Jan;98(1):21-5
references.pmid: 15676161
references.citation: Circ Cardiovasc Imaging. 2010 Sep;3(5):632-4
references.pmid: 20841555
references.citation: Can J Cardiol. 2007 Sep;23(11):909-12
references.pmid: 17876387
references.citation: AJR Am J Roentgenol. 2007 Dec;189(6):W312-4
references.pmid: 18029841
references.citation: Ann Thorac Surg. 2000 Apr;69(4):1209-15
references.pmid: 10800821