Congenital pericardial defects are rare, occurring in approximately 1 in 14 000 necropsies. They are usually undetected during life and fewer than 200 cases are reported in world literature.1 Modes of presentation include chest pain, syncope, embolisation from mural thrombus, pericarditis or sudden death. We report a 34 year old woman with chest pain in whom the diagnosis was suggested by chest radiography and confirmed by magnetic resonance imaging. Management was by video assisted thoracoscopic partial pericardiectomy.