Where is the Missing Piece of the Puzzle? | Patient Case Quiz

A 27-year-old asymptomatic professional athlete presents for a cardiac evaluation after a preparticipation EKG stress test showed a 4 beat run of nonsustained ventricular tachycardia. He achieved 17 METs without symptoms. An echocardiogram demonstrated mildly enlarged right ventricle and mild left ventricular hypertrophy. Due to these abnormalities, a cardiac MRI was done and revealed partial absence of pericardium (Figure 1). A subsequent stress echocardiogram and Holter monitor was normal with only occasional ventricular premature beats. The athlete denied any episodes of chest pain, dyspnea, dizziness, syncope with rest or with heavy physical exertion. After review of his testing he was cleared for participation in professional sports without any restriction.

Figure 1

Figure 1
MRI SSFP cine image. Parietal and visceral pericardium is seen next to right ventricle and part of left ventricle (white arrow heads). There is absence of pericardium across the lateral wall of left ventricle (large white arrow).

All of the following are true statements regarding congenital absence of pericardium EXCEPT?

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