REVIEW ARTICLE
Epipericardial fat necrosis: a systematic literature review
1
Student’s Scientific Group of Radiology, Jagiellonian University Medical College, Krakow, Poland
2
Jagiellonian University Medical College, Krakow, Poland
3
Faculty of Medicine, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
Submission date: 2025-08-21
Final revision date: 2025-09-06
Acceptance date: 2025-09-15
Online publication date: 2026-10-12
KEYWORDS
TOPICS
ABSTRACT
Epipericardial fat necrosis (EFN) is a rare, benign condition characterised by localised inflammation and necrosis of fat surrounding the heart. We performed a systematic review of EFN cases published up to June 2024, identifying 61 patients from 46 articles. The mean age was 46.4 years, with a male predominance (60.7%). Nearly all presented with chest pain (98.4%), and pleural symptoms were common (65.6%). EFN was usually left-sided (80.3%), appearing as an encapsulated mass (60.7%) with dense stranding (57.4%). Computed tomography (CT) density was variable, while pleural effusion occurred in 37.7%. Reported management included analgesics or nonsteroidal anti-inflammatory drugs, corticosteroids, and surgical intervention. Among the 36 patients with available follow-up imaging, regression was reported in all cases. Despite its variable presentation, EFN is a self-limiting condition, and CT remains the most reliable imaging modality for diagnosis.
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| ISSN: | 1899-1874 |
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