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Pericardial defects are a rare condition, generally asymptomatic, due to failure in development of pericardial sac. They are difficult to detect, particularly the complete absence of the pericardium. At present magnetic resonance imaging (MRI) is considered the best performing exam and it could be the first choice in the diagnosis of agenesia of the pericardium.A comprehensive review of dedicated books and PubMed literature was performed and three clinical cases have been analyzed.We report three cases, one with partial and two with total agenesia of the left pericardium, seen at our Institute and diagnosed at MRI as unexpected findings.The diagnosis of a congenital defect of the pericardium is challenging, even for expert radiologists, because this kind of deformity does not provide specific clinical nor conventional radiology findings. Nowadays, the most effective instrument for a certain diagnosis is MRI, interlocked with electrocardiography.

Congenital defects of pericardium: case reports and review of literature.