Pericardial fat pad

Pericardial fat pads are normal structures that lie in the cardiophrenic angle. They are adipose tissues surrounding the heart composed of the epicardial fat, which lies between the myocardium and visceral pericardium, and paracardial fat, which is adherent and external to the parietal pericardium. Unsurprisingly, they are more prominent in obese patients.

Pathology

They can be affected by fat necrosis, see: pericardial fat necrosis.

Radiographic features

Plain radiograph
  • mass or hazy opacity in the cardiophrenic angle
  • cardiac and diaphragmatic silhouettes usually visible
CT
  • easily differentiates pericardial fat pad from pathology other than a lipoma

Differential diagnosis

At times they are large enough to simulate pathology and can be mistaken for:

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