An epicardial problem case report: multimodality imaging assessment of a patient presenting with symptomatic ventricular tachycardia, secondary to a large, epicardial, lipomatous mass with myocardial infiltration.

Cardiac lipomas are considered benign and slow-growing adipose tissue tumours; however, the size and location can cause significant haemodynamic compromise and therefore can be malignant in clinical presentation. The clinical case describes a rare presentation of a 50-year-old patient, presenting with recurrent haemodynamically compromising ventricular arrhythmia; secondary to an incredibly large, epicardial lipomatous mass, with associated combination of myocardial infiltration, left ventricular systolic impairment, and complex cardiac circulatory involvement. The case illustrates the ESC guidelines on the benefits of complimentary multimodality cardiac imaging to assess complex pericardial disease, to improve both clinical understanding and management.