The Herniated Heart: A Rare Cause of Myocardial Infarction Identified by Multimodality Imaging.

• Myocardial herniation through a pericardial defect can mimic acute STEMI. • Dynamic coronary compression in diastole suggests extrinsic vessel obstruction. • Multimodality imaging is critical to diagnose congenital pericardial defects. • Partial pericardial defects can cause myocardial strangulation or sudden death. • Surgical repair of pericardial defects may prevent life-threatening complications.