Skip to content
DraconiticResearch
Search Sources API
203,234 studies31 sourcesUpdated 19 min ago
Peer-reviewedCC BYDiagnostics (Basel, Switzerland)

The Snoopy Sign Behind a MINOCA: Complete Congenital Absence of the Pericardium.

  • Claudiu-Florin Rășinar1,2
  • Silvia Ana Luca1,2,3
  • Florin Mircea Giru1,2
  • Simina Crisan1,3
  • Corina Maria Vasile4,5
  • Constantin Tudor Luca1,3,6
6 affiliations
  1. 1Department of Cardiology, Institute of Cardiovascular Diseases, 300310 Timișoara, Romania.
  2. 2Doctoral School, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timișoara, Romania.
  3. 3Cardiology Department, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timișoara, Romania.
  4. 4Department of Cardiovascular Surgery, Institute of Cardiovascular Diseases, 300310 Timișoara, Romania.
  5. 5Department of Radiology, Columbia University, New York, NY 10032, USA.
  6. 6Research Center of the Institute of Cardiovascular Diseases, 300310 Timișoara, Romania.
Read full textPDFDOICite

Abstract

Background: Myocardial infarction with non-obstructive coronary arteries (MINOCA) requires further investigation to identify the underlying mechanism. Congenital absence of the pericardium is a rare anomaly, usually asymptomatic and incidentally diagnosed. Case Presentation: A 57-year-old woman presented with prolonged resting chest pain, inferior T-wave inversion, and markedly elevated high-sensitivity cardiac troponin I (4393 ng/L). Transthoracic echocardiography was limited by non-diagnostic standard views and revealed marked cardiac displacement with preserved left ventricular systolic function. Coronary angiography showed unobstructed coronary arteries but raised suspicion of an anomalous right coronary origin. Coronary computed tomography angiography excluded this anomaly and demonstrated complete absence of the pericardium with marked leftward cardiac displacement. Cardiac magnetic resonance confirmed the anatomical diagnosis and showed preserved biventricular systolic function, no late gadolinium enhancement, and diffusely elevated T2 and extracellular volume, consistent with acute non-ischemic myocardial injury. The patient recovered with conservative management and remained asymptomatic at follow-up. Conclusions: Complete congenital absence of the pericardium may be identified during the evaluation of an acute MINOCA-like presentation. Unusual echocardiographic windows, marked cardiac displacement, and difficult coronary engagement should raise suspicion of this anomaly. Multimodality imaging is essential for defining the anatomy, excluding associated coronary abnormalities, and characterizing myocardial injury.

Related

  1. Is late congenital autoimmune complete heart block possible? A case report.
    Frederico Scuotto, Maria Fernanda Silva Jardim, Pedro Gabriel M Barros E Silva +3
    HeartRhythm case reportsPeer-reviewedCC BY-NC-NDFull textCardiovascular medicineEurope PMC
  2. Perinatal multidisciplinary management for neonates with prenatally-diagnosed congenital complete heart block undergoing early epicardial pacemaker implantation: a retrospective single-center case series
    Huiyan Cang, Guangzhi Jia, Di Zhang +2
    The Journal of Maternal-Fetal & Neonatal MedicinePeer-reviewedCC BYFull textCardiovascular medicineDOAJ
  3. NSAID Tolerance Can Be Restored in NECD Even in the Absence of Complete Remission of Urticaria.
    Merve Hormet Igde, Pelin Korkmaz, Semra Demir +12
    Clinical and translational allergyPeer-reviewedCC BYFull textGeneral medicineEurope PMC
  4. Polyurethane versus pericardium: Contrasting hemocompatibility in 2 different total artificial hearts.
    Joseph Roux de Bezieux, Elodie Boissier, Peter Ivak +8
    JTCVS openPeer-reviewedCC BYFull textGeneral medicineEurope PMCPMC
  5. Desmoplastic Malignant Mesothelioma of the Pericardium Mimicking Inflammatory Pericardial Disease: An Autopsy Case Report
    Manami Shingu, Takamasa Ohnishi, Yoshihito Horii +3
    Internal MedicinePeer-reviewedCC BY-NC-NDFull textGeneral medicineJ-STAGE

Cite

BibTeXRIS
BibTeX
@article{rașinar2026snoopy,
  title = {{The Snoopy Sign Behind a MINOCA: Complete Congenital Absence of the Pericardium.}},
  author = {Claudiu-Florin Rășinar and Silvia Ana Luca and Florin Mircea Giru and Simina Crisan and Corina Maria Vasile and Constantin Tudor Luca},
  journal = {Diagnostics (Basel, Switzerland)},
  year = {2026},
  month = sep,
  doi = {10.3390/diagnostics16193159},
  url = {https://europepmc.org/article/MED/42882314},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - The Snoopy Sign Behind a MINOCA: Complete Congenital Absence of the Pericardium.
AU  - Claudiu-Florin Rășinar
AU  - Silvia Ana Luca
AU  - Florin Mircea Giru
AU  - Simina Crisan
AU  - Corina Maria Vasile
AU  - Constantin Tudor Luca
PY  - 2026
DA  - 2026/09/29
JO  - Diagnostics (Basel, Switzerland)
DO  - 10.3390/diagnostics16193159
UR  - https://europepmc.org/article/MED/42882314
AB  - Background: Myocardial infarction with non-obstructive coronary arteries (MINOCA) requires further investigation to identify the underlying mechanism. Congenital absence of the pericardium is a rare anomaly, usually asymptomatic and incidentally diagnosed. Case Presentation: A 57-year-old woman presented with prolonged resting chest pain, inferior T-wave inversion, and markedly elevated high-sensitivity cardiac troponin I (4393 ng/L). Transthoracic echocardiography was limited by non-diagnostic standard views and revealed marked cardiac displacement with preserved left ventricular systolic function. Coronary angiography showed unobstructed coronary arteries but raised suspicion of an anomalous right coronary origin. Coronary computed tomography angiography excluded this anomaly and demonstrated complete absence of the pericardium with marked leftward cardiac displacement. Cardiac magnetic resonance confirmed the anatomical diagnosis and showed preserved biventricular systolic function, no late gadolinium enhancement, and diffusely elevated T2 and extracellular volume, consistent with acute non-ischemic myocardial injury. The patient recovered with conservative management and remained asymptomatic at follow-up. Conclusions: Complete congenital absence of the pericardium may be identified during the evaluation of an acute MINOCA-like presentation. Unusual echocardiographic windows, marked cardiac displacement, and difficult coronary engagement should raise suspicion of this anomaly. Multimodality imaging is essential for defining the anatomy, excluding associated coronary abnormalities, and characterizing myocardial injury.
SN  - 2075-4418
ER  -