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Peer-reviewedCC BY 4.0Frontiers in Cardiovascular Medicine

Idiopathic chylopericardium temporally associated with short-term high-fat dietary excess in a young man: a case report

  1. 1Department of Emergency Medicine and Institute of Disaster Medicine, Institute of Emergency Medicine, West China School of Medicine, West China Hospital, Sichuan University
  2. 2Department of Pathology, West China Second University Hospital, Sichuan University

Abstract

Idiopathic chylopericardium is a rare and potentially serious condition typically managed conservatively, though surgical intervention is often required. This case report describes a 22-year-old man with no significant past medical history who presented with acute chest pain and dyspnea following a one-week period of excessive high-fat dietary intake. Physical examination revealed a characteristic forward-leaning posture. Laboratory evaluation demonstrated hypertriglyceridemia, while imaging confirmed moderate pericardial effusion without tamponade or constriction. Pericardiocentesis yielded 350 mL of chylous fluid, and subsequent lymphoscintigraphy suggested cessation of radiotracer transit at the supradiaphragmatic level. Comprehensive serologic testing ruled out infectious, autoimmune, and neoplastic etiologies. Following a presumptive diagnosis of idiopathic chylopericardium, the patient was successfully treated with a fat-restricted diet and octreotide, leading to complete symptom resolution and no recurrence at 2-month follow-up. This case highlights a temporal association between an extreme short-term high-fat dietary intake and the subsequent development of idiopathic chylopericardium. However, causality cannot be established based on a single case, and the current evidence supports only an association rather than a causal relationship, and supports the efficacy of conservative treatment in selected patients without hemodynamic compromise.

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BibTeX
@article{liang2026idiopathic,
  title = {{Idiopathic chylopericardium temporally associated with short-term high-fat dietary excess in a young man: a case report}},
  author = {Lianjing Liang and Shitong Su and Peng Yao and Yu Cao},
  journal = {Frontiers in Cardiovascular Medicine},
  year = {2026},
  month = oct,
  doi = {10.3389/fcvm.2026.1863669},
  url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1863669/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Idiopathic chylopericardium temporally associated with short-term high-fat dietary excess in a young man: a case report
AU  - Lianjing Liang
AU  - Shitong Su
AU  - Peng Yao
AU  - Yu Cao
PY  - 2026
DA  - 2026/10/08
JO  - Frontiers in Cardiovascular Medicine
DO  - 10.3389/fcvm.2026.1863669
UR  - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1863669/full
AB  - Idiopathic chylopericardium is a rare and potentially serious condition typically managed conservatively, though surgical intervention is often required. This case report describes a 22-year-old man with no significant past medical history who presented with acute chest pain and dyspnea following a one-week period of excessive high-fat dietary intake. Physical examination revealed a characteristic forward-leaning posture. Laboratory evaluation demonstrated hypertriglyceridemia, while imaging confirmed moderate pericardial effusion without tamponade or constriction. Pericardiocentesis yielded 350 mL of chylous fluid, and subsequent lymphoscintigraphy suggested cessation of radiotracer transit at the supradiaphragmatic level. Comprehensive serologic testing ruled out infectious, autoimmune, and neoplastic etiologies. Following a presumptive diagnosis of idiopathic chylopericardium, the patient was successfully treated with a fat-restricted diet and octreotide, leading to complete symptom resolution and no recurrence at 2-month follow-up. This case highlights a temporal association between an extreme short-term high-fat dietary intake and the subsequent development of idiopathic chylopericardium. However, causality cannot be established based on a single case, and the current evidence supports only an association rather than a causal relationship, and supports the efficacy of conservative treatment in selected patients without hemodynamic compromise.
SN  - 2297-055X
ER  -