A 16-year-old girl presented to the emergency department with orthopnea and exercise intolerance for 1 week. Electrocardiogram at that time showed rightward deviation of the cardiac axis, with nonspecific T-wave inversion in the lateral precordial leads and flattening in the inferior leads. She was discharged from the emergency department with cardiology follow-up. Subsequent echocardiogram demonstrated that “the heart is in a funny position in the chest,” and computed tomography of the chest was requested to evaluate for a mediastinal mass causing leftward displacement of the heart.
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Nikam, R., Rapp, J., Kandula, A., Puram, S., & Saul, D. (2020). Congenital absence of pericardium. Annals of Pediatric Cardiology, 13(4), 373–374. https://doi.org/10.4103/apc.APC_137_20