Publicação
Epipericardial fat necrosis in chest CT and MRI: a case report of an unusual cause of chest pain associated with the initial diagnosis of undifferentiated connective tissue disease
| dc.contributor.author | Barreto, Inês | |
| dc.contributor.author | Oliveira, Francisca Godinho | |
| dc.contributor.author | Barreira, Sofia | |
| dc.contributor.author | Inácio, João R. | |
| dc.date.accessioned | 2023-07-18T10:54:40Z | |
| dc.date.available | 2023-07-18T10:54:40Z | |
| dc.date.issued | 2023 | |
| dc.description | © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. | pt_PT |
| dc.description.abstract | Background: Epipericardial fat necrosis (EFN) is a benign and self-limited condition of unknown cause with a good prognosis, usually affecting otherwise healthy patients. Clinically, it presents with severe acute left pleuritic chest pain, often leading the patient to the Emergency Room (ER). Case presentation: A 23-year-old male, smoker (5 pack-years), was evaluated in the ER due to left pleuritic chest pain, worsening with deep breathing and Valsalva maneuver. It was not associated with trauma and did not present other symptoms. The physical examination was unremarkable. The arterial blood gases while breathing room air and the laboratory tests, including D-dimers and high-sensitivity cardiac Troponin T, were normal. The chest radiograph, electrocardiogram, and transthoracic echocardiogram showed no abnormalities. A computed tomography (CT) pulmonary angiogram showed no signs of pulmonary embolism but depicted at the left cardiophrenic angle a focal 3 cm ovoid-shaped fat lesion with stranding and thin soft tissue margins, consistent with necrosis of the epicardial fat, which was confirmed by magnetic resonance (MRI) of the chest. The patient was medicated with ibuprofen and pantoprazole, with clinical improvement in four weeks. At a two-month follow-up, he was asymptomatic and presented radiologic resolution of the inflammatory changes of the epicardial fat of the left cardiophrenic angle on chest CT. Laboratory tests revealed positive antinuclear antibodies, positive anti-RNP antibody, and positive lupus anticoagulant. The patient complained of biphasic Raynaud's phenomenon initiated five years ago, and a diagnosis of undifferentiated connective tissue disease (UCTD) was made. Conclusions: This case report highlights the diagnosis of EFN as a rare and frequently unknown clinical condition, which should be considered in the differential diagnosis of acute chest pain. It can mimic emergent conditions such as pulmonary embolism, acute coronary syndrome, or acute pericarditis. The diagnosis is confirmed by CT of the thorax or MRI. The treatment is supportive and usually includes non-steroidal anti-inflammatory drugs. The association of EFN with UCTD has not been previously described in the medical literature. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | BMC Cardiovasc Disord. 2023 Jun 22;23(1):314 | pt_PT |
| dc.identifier.doi | 10.1186/s12872-023-03349-x | pt_PT |
| dc.identifier.eissn | 1471-2261 | |
| dc.identifier.uri | http://hdl.handle.net/10451/58647 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | Springer Nature | pt_PT |
| dc.relation.publisherversion | https://bmccardiovascdisord.biomedcentral.com/ | pt_PT |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | pt_PT |
| dc.subject | CT | pt_PT |
| dc.subject | Chest pain | pt_PT |
| dc.subject | Epipericardial fat necrosis | pt_PT |
| dc.subject | MRI | pt_PT |
| dc.subject | Undifferentiated connective tissue disease | pt_PT |
| dc.title | Epipericardial fat necrosis in chest CT and MRI: a case report of an unusual cause of chest pain associated with the initial diagnosis of undifferentiated connective tissue disease | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.issue | 1 | pt_PT |
| oaire.citation.title | BMC Cardiovascular Disorders | pt_PT |
| oaire.citation.volume | 23 | pt_PT |
| person.familyName | Silva e Costa de Castro Barreto | |
| person.familyName | Barreira | |
| person.familyName | Inácio | |
| person.givenName | Inês | |
| person.givenName | Sofia | |
| person.givenName | João | |
| person.identifier.ciencia-id | 0B15-5593-5189 | |
| person.identifier.ciencia-id | 2417-2F03-44CD | |
| person.identifier.orcid | 0000-0002-1127-4811 | |
| person.identifier.orcid | 0000-0002-6807-559X | |
| person.identifier.orcid | 0000-0003-3210-3285 | |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |
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| relation.isAuthorOfPublication.latestForDiscovery | e043a8fc-35de-4b09-af6a-c23e3851a967 |