What is epicardial fat?
- Epicardial fat pad is a normal structure that lies between the myocardium and the visceral pericardium¹.
- It is more prominent in obese patients and can be associated with coronary artery disease, diabetes, arrhythmias, and other cardiac conditions⁶.
- Ultrasound imaging: can show the epicardial fat as echogenic tissue around the right heart, especially on the subcostal view³.
- The following are two examples of ultrasound images showing the epicardial fat pad:
Image 1: A subcostal view of the heart showing a prominent epicardial fat pad (arrow) as a bright layer around the right ventricle (RV). The liver (L) is seen below the heart. The left ventricle (LV) and the pericardium (P) are also visible.
Image 2: Another subcostal view of the heart showing a large epicardial fat pad (arrow) extending from the right atrium (RA) to the apex of the right ventricle (RV). The liver (L) is seen below the heart. The left ventricle (LV) and the pericardium (P) are also visible.
- The prognosis and management of epicardial fat pad depend on the underlying cardiac condition and the presence of symptoms⁶.
- In most cases, conservative treatment with weight loss, exercise, and medications can reduce the amount of epicardial fat and improve cardiac function⁸.
- In rare cases, surgical removal of epicardial fat may be indicated for symptomatic patients.
For an ebook on interesting ultrasound imaging cases, on Amazon Kindle, you can download this:
(1) Pericardial fat pads | Radiology Reference Article | Radiopaedia.org. https://radiopaedia.org/articles/pericardial-fat-pads-2.
(2) Epicardial Adipose Tissue: A Predictor of Coronary Artery Disease. https://www.healthline.com/health/coronary-artery-disease/epicardial-adipose-tissue-coronary-artery-disease.
(3) Potential Errors in the Diagnosis of Pericardial Effusion on Trauma .... https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1553-2712.2000.tb00472.x.
(4) Understanding Epicardial Fat | Premier Health. https://www.premierhealth.com/your-health/articles/health-topics/understanding-epicardial-fat.
(5) Epipericardial fat necrosis | Radiology Reference Article - Radiopaedia.org. https://radiopaedia.org/articles/epipericardial-fat-necrosis-1?lang=us.
(6) Epicardial fat pad | Radiology Case | Radiopaedia.org. https://radiopaedia.org/cases/epicardial-fat-pad.
(7) What does pericardial fat pad mean? - Studybuff.com. https://studybuff.com/what-does-pericardial-fat-pad-mean/.
(8) Pericardial effusion | Radiology Reference Article | Radiopaedia.org. https://radiopaedia.org/articles/pericardial-effusion.
(9) Pericardial cyst - Wikipedia. https://en.wikipedia.org/wiki/Pericardial_cyst.
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