PMID- 23580923
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20130415
LR  - 20211021
IS  - 1995-705X (Print)
IS  - 0976-5123 (Electronic)
IS  - 1995-705X (Linking)
VI  - 14
IP  - 1
DP  - 2013 Jan
TI  - Congenital complete absence of pericardium masquerading as pulmonary embolism.
PG  - 29-32
LID - 10.4103/1995-705X.107118 [doi]
AB  - Congenital absence of the pericardium is a rare cardiac condition, which can be 
      either isolated or associated with other cardiac and extracardiac anomalies. 
      There are six different types, depending on the severity of the involvement. Most 
      of the patients with this defect are asymptomatic, especially the ones with 
      complete absence of the pericardium. However, some patients are symptomatic, 
      reporting symptoms that include chest pain, palpitations, dyspnea, and syncope. 
      Diagnosis is established by the characteristic features on chest X-ray, 
      echocardiogram, chest computed tomography (CT), and/or cardiac magnetic resonance 
      imging (MRI). We present here a case of a 23 year-old-male, who presented to our 
      hospital with complaints of pleuritic chest pain and exertional dyspnea, of a 
      two-week duration. He was physically active and his past history was otherwise 
      insignificant. His chest CT with contrast was interpreted as showing evidence of 
      multiple emboli, predominantly in the left lung, and he was started on a heparin 
      and warfarin therapy. A repeat chest CT with contrast three weeks later showed no 
      significant change from the previous CT scan. Both scans showed that the heart 
      was abnormally rotated to the left side of the chest. An echocardiogram raised 
      the suspicion of congenital absence of the pericardium, with a posteriorly 
      displaced heart. In retrospect, motion artifact on the left lung, attributed to 
      cardiac pulsations and the lack of pericardium, resulted in a CT chest 
      appearance, mimicking findings of pulmonary embolism. The misdiagnosis of 
      pulmonary embolism was attributed to the artifact caused by excessive cardiac 
      motion artifact on the chest CT scan. In non-gated CT angiograms, excessive 
      motion causes an artifact that blurs the pulmonary vessels, reminiscent of a 
      'seagull' or a 'boomerang'. Physicians need to be aware of this phenomenon, as 
      well as the characteristic radiological features of this congenital anomaly, to 
      enable them to make a correct diagnosis.
FAU - Tariq, Saad
AU  - Tariq S
AD  - Department of Internal Medicine, St Francis Medical Center, Trenton, New Jersey, 
      USA.
FAU - Mahmood, Sultan
AU  - Mahmood S
FAU - Madeira, Samuel
AU  - Madeira S
FAU - Tarasov, Ethan
AU  - Tarasov E
LA  - eng
PT  - Case Reports
PL  - India
TA  - Heart Views
JT  - Heart views : the official journal of the Gulf Heart Association
JID - 101316474
PMC - PMC3621222
OTO - NOTNLM
OT  - Cardiology
OT  - congenital anomaly
OT  - radiology
COIS- Conflict of Interest: None declared.
EDAT- 2013/04/13 06:00
MHDA- 2013/04/13 06:01
PMCR- 2013/01/01
CRDT- 2013/04/13 06:00
PHST- 2013/04/13 06:00 [entrez]
PHST- 2013/04/13 06:00 [pubmed]
PHST- 2013/04/13 06:01 [medline]
PHST- 2013/01/01 00:00 [pmc-release]
AID - HV-14-29 [pii]
AID - 10.4103/1995-705X.107118 [doi]
PST - ppublish
SO  - Heart Views. 2013 Jan;14(1):29-32. doi: 10.4103/1995-705X.107118.