{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T05:06:42Z","timestamp":1766725602045,"version":"3.48.0"},"reference-count":14,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,11]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Pericardial fat necrosis (PFN) is a rare, benign cause of acute pleuritic chest pain, sharing symptomatic overlap with more serious cardiopulmonary conditions. We present a case of a woman in her early 50s who experienced progressive, left-sided pleuritic chest pain. Initial investigations, including an ECG, troponin and D-dimer, were negative. On re-presentation, inflammatory markers were raised and a small left pleural effusion was noted. CT pulmonary angiography, performed to exclude pulmonary embolism, revealed focal pericardial fat inflammation, retrospectively diagnosed as PFN. Follow-up imaging demonstrated complete resolution, consistent with the self-limiting nature of the condition. This case highlights the diagnostic challenge posed by PFN, given its non-specific symptoms which often mimic more serious acute pathology. Given that many patients undergo CT imaging as part of their work-up, awareness of PFN can prevent unnecessary, and potentially invasive, further investigations.<\/jats:p>","DOI":"10.1136\/bcr-2025-269865","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T05:05:20Z","timestamp":1766725520000},"page":"e269865","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Pericardial fat necrosis: an underdiagnosed cause of acute chest pain"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9375-5732","authenticated-orcid":false,"given":"Krishan Ragab","family":"Bansal","sequence":"first","affiliation":[{"name":"Respiratory Medicine, NHS North Bristol NHS Trust, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Crook","sequence":"additional","affiliation":[{"name":"University of Bristol Academic Respiratory Unit, Westbury on Trym, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Cooper","sequence":"additional","affiliation":[{"name":"Radiology Department, Southmead Hospital, Bristol, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,25]]},"reference":[{"key":"2025122521051205000_18.12.e269865.1","doi-asserted-by":"crossref","DOI":"10.1177\/1179547620940769","article-title":"Epipericardial Fat Necrosis: A Case Report and a Review of the Literature","volume":"13","author":"Mortensen","year":"2020","journal-title":"Clin Med Insights Case Rep"},{"key":"2025122521051205000_18.12.e269865.2","doi-asserted-by":"crossref","first-page":"773","DOI":"10.2214\/AJR.15.15934","article-title":"Epipericardial Fat Necrosis: Who Should Be a Candidate?","volume":"207","author":"Giassi","year":"2016","journal-title":"AJR Am J Roentgenol"},{"key":"2025122521051205000_18.12.e269865.3","doi-asserted-by":"publisher","DOI":"10.5603\/CJ.2012.0076"},{"key":"2025122521051205000_18.12.e269865.4","doi-asserted-by":"crossref","unstructured":"Accorsi TAD , Paix\u00e3o MR , Piorino E de MS , et al . Epipericardial fat necrosis as a differential diagnosis of acute chest pain: a case report and algorithm proposal for diagnostic approach. 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