What's a pericardial fat pad?

A question for the medical dopers!

What the heck is a “pericardial fat pad”?

Here’s the background story. I went for a visa-related medical, and needed a chest x-ray (to rule out TB!). The radiologist found nothing indicating I was a walking infectious disease, but did find what he described as a “prominent right pericardial fat pad.”

I’m 25, not significantly overweight at all, eat well, exercise, etc… But my family has a history of heart disease.

The radiologist and the referring doctor insisted that I consult my family doctor ASAP to have a look at this. At the same time, the radiologist’s report read that this is likely of “no clinical significance” in the great scheme of things.

So - my question is simple: What the heck is a pericardial fat pad? What does it do? What does it cause?


The pericardial fat pad is a fat pad on the pericardium, a sac which encloses the heart. The epicardial fat pad is a fat pad on the epicardium, or outer surface of the heart.

As near as I can tell (and from what I remember), the pericardial fat sac is totally useless, except as a surgical aid to stop blood and air leakage in thoracic surgery. Where it gets a little confusing is that the pericardium has two layers, the visceral layer affixed to the heart and a parietal layer which makes up the sac in which the heart sits. The epicardial fat pad sign is a separation of the fat pads between these two layers. As near as I can tell, this means between the pericardial and epicardial fat pads.

The epicardial fat pad sign can indicate a pericardial effusion. This can be caused by a few different things, and can be dangerous, so it should be worked up. This probably will start with a good heart and circulation exam, including pulse pressures, heart sounds, and jugular venous distention with hepatojugular reflexes and the like (pressing on your belly and looking at your neck). From there, it can go to EKG, and perhaps other scans like echocardiography or chest CT or MRI.


Thanks for the info, Edwino.

I’ll be sure to have it looked into! I just like the words “fat pad”. Makes me wanna write a country music song about the “fat pad of my heaaaart…”