Epipericardial Fat Necrosis. An Important Differential Diagnosis of Chest Pain

Introduction

Epipericardial fat necrosis (EPFN) is a rare, benign, and self-limiting condition, first described in 1957 by Jackson et al. Currently, there are only 33 cases described in the literature.^–

The pathophysiology of the disease remains uncertain. Likely predisposing factors include torsion of the vascular pedicle of adipose tissue, structural alterations that make the tissue more vulnerable and obesity, which, like the Valsalva maneuver, can lead to increased capillary pressure, causing hemorrhage into the adipose tissue. There are also reports of association with chest trauma or infections.

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