An Often-Overlooked Etiology of Pleuritic Chest Pain
KEY WORDSClinical image Diagnosis Cardiovascular disease Pulmonary disease
EPFN is an often-overlooked etiology of pleuritic chest pain in patients with a negative cardiopulmonary workup.1 Onset is usually acute, but can persist up to a year. ECG and lab tests are usually normal. CXR often shows a paracardiac opacity, occasionally with an associated pleural effusion. CT shows an ovoid density in the juxtapericardial fat, with prominent stranding extending to the pericardial surface with inflammatory changes of the pericardium.2 The triad of pleuritic chest pain, classic CT findings, and negative cardiopulmonary work-up is highly suggestive of EPFN.3 Because of its self-limiting nature, the treatment is conservative management with NSAIDs.4 Follow-up imaging is recommended to confirm resolution and exclude neoplastic diseases such as liposarcoma.
Conflict of interest
The authors report no conflicts of interest related to the work described in this manuscript.