Junqi Gou, Fengyou Yao, Chaohui Liu, Mingjian Lang, Xiaobo Jiang
Department of Cardiology, Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China.
Front Cardiovasc Med. 2025 Aug 12;12:1624625. doi: 10.3389/fcvm.2025.1624625. eCollection 2025.
Congenital absence of the pericardium (CAP) is a rare cardiac anomaly with an estimated prevalence of <1:10,000. CAP results from premature atrophy of the left common cardinal vein during embryogenesis, leading to pericardial defects. In this report, the case of a 39-year-old male with recurrent left-sided chest tightness who was initially misdiagnosed with pulmonary embolism (PE) is presented. Anticoagulation failed to resolve symptoms, prompting advanced imaging and multidisciplinary team review, which confirmed CAP. Conservative management was chosen because of mild symptoms and low herniation risk. This case underscores the diagnostic complexity of CAP and highlights the role of advanced imaging in differentiating CAP from PE. Clinicians should consider CAP in patients with nonspecific cardiac symptoms and imaging findings of cardiac displacement or abnormal mobility.
先天性心包缺如（CAP）是一种罕见的心脏异常，估计患病率<1:10000。CAP是由于胚胎发育过程中左总主静脉过早萎缩导致心包缺损所致。在本报告中，介绍了一名39岁男性反复出现左侧胸闷的病例，该患者最初被误诊为肺栓塞（PE）。抗凝治疗未能缓解症状，促使进行高级影像学检查和多学科团队会诊，最终确诊为CAP。由于症状较轻且疝形成风险较低，故选择保守治疗。该病例强调了CAP的诊断复杂性，并突出了高级影像学在鉴别CAP与PE中的作用。临床医生应在有非特异性心脏症状以及心脏移位或活动异常影像学表现的患者中考虑CAP。
