Epipericardial fat necrosis and COVID-19
  • Mohsin Haseeb
    Department of Cardiology, University of Illinois College of Medicine, Peoria, USA
  • Abdullah Shafiq
    Department of Cardiology, Southern Illinois University, Illinois, USA
  • Muhammad A. Sheikh
    Department of Cardiology, Southern Illinois University, Illinois, USA
  • Muhammad F. Khan
    Department of Cardiology, Southern Illinois University, Illinois, USA


Epipericardial fat necrosis, chest pain, COVID-19, epipericardial adipose tissue


Background: Epipericardial fat necrosis (EFN) is a rare and self-limiting cause of acute chest pain. We describe a case of EFN in a patient with a recent coronavirus disease (COVID-19).
Case Presentation: A 55-year-old male presented with a sudden onset of left-sided pleuritic chest pain for the past two days. The patient was diaphoretic, tachypneic, and tachycardic. Acute coronary syndrome was ruled out. A computed tomography (CT) pulmonary angiogram revealed an ovoid encapsulated fatty mass surrounded by dense appearing tissue. Patient symptoms improved remarkably with a short course of non-steroidal anti-inflammatory drugs (NSAIDs).
Discussion: EFN typically presents with a sudden onset of excruciating chest pain. Misdiagnosis, under-diagnosis, and mismanagement are unavoidable. EFN is incidentally diagnosed on CT scan. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects visceral adipose tissue and appears to increase the risk of EFN by promoting inflammatory cytokine production and death of adipocytes.
Conclusion: EFN is a rare cause of acute chest pain. SARS-CoV-2 is likely to induce EFN. This rare clinical entity should be considered in the differential of acute chest pain especially in patients with active or recent COVID-19.



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    Published: 2024-02-29
    Issue: 2024: Vol 11 No 3 (view)

    How to cite:
    Haseeb M, Shafiq A, Sheikh MA, Khan MF. Epipericardial fat necrosis and COVID-19. EJCRIM 2024;11 doi:10.12890/2024_004346.