Identifying Epicardial Fat vs. Pericardial Thickening on Echocardiography: Key Insights

In an asymptomatic middle-aged female, echocardiography revealed a grainy 12 mm thick area around the heart, not appearing as fluid. The most likely diagnosis is epicardial fat, a benign adipose tissue layer between the myocardium and the visceral pericardium. It typically shows as a grainy or echogenic area, often located anteriorly around the right ventricle. Epicardial fat is commonly asymptomatic and found incidentally. Another possibility is pericardial thickening or fibrosis, which can occur due to chronic pericarditis, constrictive pericarditis, or previous infections. Differentiating between epicardial fat and pericardial pathology is essential, and advanced imaging, such as cardiac MRI or CT, can be useful. MRI can distinguish fat from fibrosis or calcifications due to its high signal on T1-weighted images.
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#Echocardiography #EpicardialFat #PericardialThickening #CardiacImaging #Radiology