Pericardial fat pads

Last revised by Dr Mohammad Taghi Niknejad on 30 Apr 2021

Pericardial fat pads are normal structures that lie in the cardiophrenic angle. They are adipose tissues surrounding the heart composed of the epicardial fat, which lies between the myocardium and visceral pericardium, and paracardial fat, which is adherent and external to the parietal pericardium. Unsurprisingly, they are more prominent in obese patients. 

They can be affected by fat necrosis, see: pericardial fat necrosis and inflammation directly causing coronary athetomatous disease 6

  • mass or hazy opacity in the cardiophrenic angle
  • cardiac and diaphragmatic silhouettes usually visible
  • easily differentiates pericardial fat pad from pathology other than a lipoma

At times they are large enough to simulate pathology and can be mistaken for:

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Cases and figures

  • Case 1: bilateral
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  • Case 2: at cardiac apex
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  • Case 3
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