Current reviewCongenital foramen of the left pericardium
Section snippets
Case report
On January 19, 1978, during a light snow, P.M., age 31, was roused from sleep by pain which she said, “felt like I was hit in the chest by a heart attack.” She was unable to lie flat, preferring to sit upright. Within a few moments it became more painful while spreading to the upper left chest and arm. Breathing had no effect, but moving her left arm made it worse. She went to the emergency room of the community’s hospital, where she received injections of morphine. After 4 1/2 hours of steady
Material and methods
The accounts of the foramen type of defect of the left parietal pericardium that are the basis of this review are only confirmed∗ cases reported after the 1938 review of Southworth and Stevenson [3]. This article does not represent all such reports, but only English language papers found with a MEDLINE search, citations from earlier papers, plus the case herein recorded. Defects confined to the right side of the pericardium do occur, and herniation of the right atrium has been reported, but
Results
Forty-four accounts (5 fatal, 39 nonfatal) of the foramen type of defect were retrieved. There was a fivefold male preponderance (37 to 7). Age at diagnosis ranged from 2 to 48 years, with a mean age of 20. In the 5 fatal cases, only 1 survived the 7th year. Otherwise, the ages clustered in the second and third decades, with almost two-thirds between 11 and 29 years.
Clinical features
Males predominate. Many individuals are symptom free, and about one in three defects are suspected only after a chest film is made for unrelated reasons. In those investigated for a complaint probably due to the disorder, (eg, chest discomfort, dyspnea, syncope), the most common by far is chest discomfort. Occasionally arm movement, especially the left, breathing, or turning from side to side affects the discomfort, but otherwise the character is such that it sheds little light as to cause.
Acknowledgements
The author thanks Freeman T. Bennett, MD, for helpful suggestions and critical review of this manuscript.
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Congenital partial pericardial defect confirmed based on spontaneous pneumothorax: A case report and literature review
2020, International Journal of Surgery Case ReportsCitation Excerpt :Lateral displacement of the heart is a typical finding in patients with complete absence of the pericardium. Chest X-ray may show abnormal presence of the lung tissue between the aorta and the pulmonary artery or between the heart and the diaphragm [2,5,6]. CT or MRI should be considered for patients with a suspected or diagnosed pericardial defect to assess the size and location of the defect [7,8].
Partial pericardial defect with left auricular herniation in a dog with syncope
2014, Journal of Veterinary CardiologyPericardial tear as a consequence of cardiopulmonary resuscitation (CPR) involving chest compression: A report of two postmortem cases of acute type A aortic dissection with hemopericardium
2014, Legal MedicineCitation Excerpt :Previous studies have described problematic conditions, such as a congenital pericardial defect associated with intrapericardial hemorrhage and a left hemothorax [12–15]. A congenital pericardial defect is usually found more frequently on the left side of the heart [25] and is characterized by a round to oval-shape with a smooth and thickened rim [26]. The pericardial defects in our cases had a convex lens-shape, indicating that there was no congenital background.
The role of post-mortem imaging in a case of sudden death due to ascending aorta aneurysm rupture
2013, Forensic Science InternationalCitation Excerpt :As a consequence, the diagnosis is frequently reached intra-operatively or during post-mortem examination [20–26]. However, non-invasive, ante-mortem diagnosis of pericardial defects has been previously described using CT and MRI [20,27,28]. Regarding on the nature of the pericardial defect, we could not distinguish between traumatic and congenital origin, based solely on post-mortem imaging.
Familial complete congenital absence of the pericardium
2007, Clinical RadiologyMultimodality Imaging Approach Evaluation of the Congenital Pericardial Defect: a Contemporary Review
2023, Current Cardiology Reports