Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2008;61:311-2 - Vol. 61 Num.03 DOI: 10.1016/S1885-5857(08)60119-X

Congenital Absence of the Pericardium: A Case Report

Estibaliz Gómez a, Laura Oleaga a

a Servicio de Radiodiagnóstico, Hospital de Basurto, Bilbao, Vizcaya, Spain

Article

A 16-year-old male handball player, seen for a routine medical check-up, was found to have an electrocardiography alteration (right frontal plane QRS axis), and heartbeat radiating toward the left axillary area.

Posterior-anterior chest x-rays (Figure 1) showed displacement of the cardiac silhouette toward the left, with no deviation of the trachea. At the left cardiac border, 3 convexities were visualized: the aortic knob, pulmonary artery, and convexity of the left atrium. In addition, 2 radiotransparent bands were seen, one between the aortic knob and the pulmonary artery, and another between the cardiac base and the left hemidiaphragm.

Figure 1.

On magnetic resonance imaging, T2-weighted gradient-echo (*) axial (Figure 2), and coronal (Figure 3) views showed left posterolateral rotation and displacement of the heart, with the apex located in a posterior position. The pericardium could not be visualized, and the recess between the aorta and the root of the left pulmonary artery was seen to be filled. A diagnosis of complete agenesis of the pericardium was established and no treatment was required.

Figure 2.

Figure 3.

In the posterior-anterior view of the chest, partial left pericardial agenesis is manifested as an extremely prominent cardiac border at the level of the left atrial appendage and the pulmonary tract, caused by protrusion of these structures through the pericardial defect. Symptomatic cases of partial agenesis and asymptomatic cases with a risk of ventricular strangulation shown imaging studies should be treated surgically.

1885-5857/© 2008 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

Cookies
x
To improve our services and products, we use cookies (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.
Cookies policy
x
To improve our services and products, we use cookies (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.