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Congenital Absence of the Left Pericardium: Clinical Findings

Capt. J. R. MORGAN; Cdr. A. K. ROGERS; and Lt. Cdr. A. D. FORKER
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▸Requests for reprints should be addressed to J. R. Morgan, M.D., Chief of Cardiology, U.S. Naval Hospital, San Diego, Calif. 92134

San Diego, California

Ann Intern Med. 1971;74(3):370-376. doi:10.7326/0003-4819-74-3-370
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Six young men were referred for evaluation of "cardiomegaly." Normal cardiac catheterization studies and diagnostic pneumothoraxes confirmed the diagnosis of complete absence of the left pericardium (without associated heart disease) in five of the six patients; these procedures were not considered necessary in the sixth patient or future patients because the clinical diagnosis had been confirmed by these studies in the five patients. The clinical findings in this entity were distinctive. There was a heaving cardiac apex in the left axilla and a systolic ejection murmur at the base. The electrocardiograms were similar in the patients with right axis deviation and clockwise rotation, and the chest roentgenogram showed levoposition of the heart. It is important to be aware of this entity so as not to confuse it with cardiomyopathy or other heart disease. The findings in another patient with partial absence of the left pericardium are presented for comparison with complete absence of the left pericardium.





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