Ultrasonic Department, China Aerospace Science & Industry Corporation 731 Hospital, No. 3, Zhen Gang Nan Li, Feng Tai District, 100074, Beijing, China.
AnoRectal Surgery, China Aerospace Science & Industry Corporation 731 Hospital, Beijing, China.
BMC Cardiovasc Disord. 2023 May 12;23(1):247. doi: 10.1186/s12872-023-03262-3.
Congenital absence of the pericardium (CAP) is rare in clinical practice, the symptoms vary among patients, and most doctors do not have enough knowledge of the condition. Most reported CAP cases are incidental findings. Therefore, this case report aimed to present a rare case of left partial CAP that presented with non-specific, possibly cardiac-related symptoms.
The patient, male, 56 years old, Asian, was admitted on March 2, 2021. The patient complained of occasional dizziness in the past week. The patient was suffering from hyperlipidemia and hypertension (stage 2), both untreated. The patient reported chest pain, palpitations, discomfort in the precordium, and dyspnea in the lateral recumbent position after strenuous activities, all of which started when he was about 15 years old. ECG showed sinus rhythm, 76 bpm, premature ventricular beats, incomplete right bundle branch block, and clockwise rotation of the electrical axis. Most of the ascending aorta could be detected in the parasternal intercostal space 2-4 by transthoracic echocardiography in the left lateral position. Chest computed tomography revealed the absence of pericardium between the aorta and the pulmonary artery, and part of the left lung was extending into the space. No changes in his condition have been reported up to now (March 2023).
CAP should be considered when multiple examinations suggest heart rotation and a large moving range of the heart in the thoracic cavity.
先天性心包缺失（CAP）在临床实践中较为罕见，患者症状各异，大多数医生对该病症的了解不足。大多数报道的 CAP 病例均为偶发发现。因此，本病例报告旨在介绍一例罕见的左部分 CAP 病例，该病例表现为非特异性、可能与心脏相关的症状。
患者，男性，56 岁，亚洲人，于 2021 年 3 月 2 日入院。患者在过去一周偶尔出现头晕。该患者患有高血脂和高血压（2 级），但均未治疗。患者自述在剧烈活动后出现胸痛、心悸、心前区不适和侧卧位呼吸困难，这些症状始于大约 15 岁时。心电图显示窦性心律，76 bpm，室性早搏，不完全性右束支传导阻滞，电轴顺时针转位。在左侧卧位时，经胸超声心动图在胸骨旁肋间 2-4 可探测到大部分升主动脉。胸部计算机断层扫描显示主动脉和肺动脉之间心包缺失，部分左肺延伸至该空间。截至 2023 年 3 月，患者病情无变化。
当多项检查提示心脏旋转和胸腔内心脏大幅度移动时，应考虑 CAP。
