Epicardial Fat Pad

Question

Asked by Jo

Epicardial Fat Pad

I had chest x-ray, showed I had loss of caudal aspect of the right heart

border, likely representing minor prominence of a epicardial fat pad.

Not sure what this means, is it dangerous, what can I do to fix it.

Answer

Jo,

Thanks for your question.

Everyone has an epicardial fat pad, which is a collection of fatty tissue outside of the heart located on the right lower heart. It varies in size from person to person and can be large enough that it obscures the right heart border when viewed on a Chest X-ray. It does not hurt the heart or interfere with its function in any way.

We usually can see the right heart border because it is next to lung tissue which is much less dense. The fat pad on the other hand has a density much closer to the heart and other structures located in the central chest area (doctors called this the mediastinum) making it difficult to distinguish the borders very well.

Again, this is very common and no cause for alarm. There is nothing you can do to change this situation, nor is there a need to.

I hope this has answered your question. Best wishes.

Martin Cane, M.D.