Partial Pericardial Defect
A 49-year-old healthy-looking man presented with vague chest discomfort in September 1995. Physical examination was unremarkable. Echocardiography revealed mild mitral valve prolapse and an incomplete pericardial echo, arousing suspicion of a partial pericardial defect. A subsequent CT scan of the thorax clearly demonstrated the incomplete pericardial defect, the rim of which was heavily calcified and constricted the partially herniated right and left ventricles (Fig 1⇓). Except for a mild focal compression at the junction of the middle and distal third of the left anterior descending coronary artery, there was no significant coronary artery abnormality on contrast angiography. On hemodynamic evaluation, no gradient was detected across the ventricular constriction. The CT findings were confirmed during surgical pericardiotomy (Fig 2⇓). Since surgery, the patient has remained physically well and asymptomatic.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke’s Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1–267, Houston, TX 77030.
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