Congenital defects of the pericardium: a review

Eur Heart J Cardiovasc Imaging. 2015 Aug;16(8):821-7. doi: 10.1093/ehjci/jev119. Epub 2015 May 23.


Pericardial defects are a rare disorder that can be characterized as acquired or congenital. Congenital defects can be further characterized by location and size of the defect, e.g. left- or right-sided and partial or complete absence of the pericardium. While physical examination and electrocardiogram are not diagnostic, chest radiographs and echocardiography have findings that should alert the clinician to the absence of the pericardium as a possible diagnosis. Despite its limitations with visualizing the normal pericardium in areas of minimal adipose, cardiac magnetic resonance is currently the gold standard for diagnosing the congenital absence of the pericardium. Patients have a similar life expectancy to those without pericardial defects; however in certain cases, herniation and strangulation of cardiac chambers can be life threatening and lead to sudden cardiac death. Treatment is tailored to the patient's symptoms, presentation, and the size and location of the defect.

Keywords: congenital; imaging; pericardium.

Publication types

  • Review

MeSH terms

  • Echocardiography
  • Electrocardiography
  • Heart Defects, Congenital / diagnosis*
  • Humans
  • Magnetic Resonance Imaging
  • Pericardium / abnormalities*
  • Radiography, Thoracic