Full calcium jacket: massive idiopathic myocardial calcification by cardiovascular magnetic resonance and cardiac CT

Revilla, Ana; Sevilla, Teresa; Sanchez, Israel Acosta; Rodríguez, Margarita; Román, José Alberto San

doi:10.1093/ehjci/jes037

Cited by 7 publications

(4 citation statements)

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“…LGE findings near the mitral and aortic valve may be explained by fibrosis in myocardium adjacent to a calcified mitral annulus or calcified aortic valve. [20][21][22][23][24][25][26] Extension of calcification, inflammation and fibrosis from aortic and mitral annular calcification has been demonstrated on necropsy which in severe cases has resulted in heart block secondary to disruption of the bundle of His. 27,28 The prevalence of aortic sclerosis in population studies is estimated to be 25% in those >65 years and climbs to 50% after 85 years of age.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and prognosis of ischaemic and non-ischaemic myocardial fibrosis in older adults

Shanbhag

Greve

Aspelund

et al. 2018

European Heart Journal

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Aims Non-ischaemic cardiomyopathies (NICM) can cause heart failure and death. Cardiac magnetic resonance (CMR) detects myocardial scar/fibrosis associated with myocardial infarction (MI) and NICM with late gadolinium enhancement (LGE). The aim of this study was to determine the prevalence and prognosis of ischaemic and non-ischaemic myocardial fibrosis in a community-based sample of older adults. Methods and results The ICELAND-MI cohort, a substudy of the Age, Gene/Environment Susceptibility Reykjavik (AGES-Reykjavik) study, provided a well-characterized population of 900 subjects after excluding subjects with pre-existing heart failure. Late gadolinium enhancement CMR divided subjects into four groups: MI (n = 211), major (n = 54) non-ischaemic fibrosis (well-established, classic patterns, associated with myocarditis, infiltrative cardiomyopathies, or pathological hypertrophy), minor (n = 238) non-ischaemic fibrosis (remaining localized patterns not meeting major criteria), and a no LGE (n = 397) reference group. The primary outcome was time to death or first heart failure hospitalization. During a median follow-up of 5.8 years, 192 composite events occurred (115 deaths and 77 hospitalizations for incident heart failure). After inverse probability weighting, major non-ischaemic fibrosis [hazard ratio (HR) 3.2, P < 0.001] remained independently associated with the primary endpoint, while MI (HR 1.4, P = 0.10) and minor non-ischaemic LGE (HR 1.2, P = 0.39) did not. Major non-ischaemic fibrosis was associated with a poorer outcome than MI (HR = 2.3, P = 0.001) in the adjusted analysis. Conclusion Major non-ischaemic patterns of myocardial fibrosis portended worse prognosis than no fibrosis/scar in an older community-based cohort. Traditional risk factors largely accounted for the effect of MI and minor non-ischaemic LGE.

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Section: Discussionmentioning

confidence: 99%

Prevalence and prognosis of ischaemic and non-ischaemic myocardial fibrosis in older adults

Shanbhag

Greve

Aspelund

et al. 2018

European Heart Journal

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“…Metastatic calcifications are a frequent cause of heart failure in patients on chronic hemodialysis 14 and have been reported to cause sudden cardiac death. 15 Calcifications may also cause focal wall motion abnormalities, 11 and lifethreatening arrhythmias can occur if there is calcification of the conduction system. 15,16 Massive myocardial calcification often results in restrictive physiology with or without decreased systolic function.…”

Section: Clinical Implications Of Myocardial Calcificationmentioning

confidence: 99%

“…Calcification will be low signal on T1 and T2 weighted magnetic resonance imaging without enhancement; however, scarred myocardium surrounding calcifications can show late gadolinium enhancement. 11 CT is the optimal modality for identifying and characterizing myocardial calcifications. Although dedicated electrocardiogramgated cardiac CT will provide the most detailed information (secondary to decreased motion artifacts), calcifications can usually be identified and localized with standard nongated chest CT.…”

Section: Imaging Findingsmentioning

confidence: 99%

Myocardial calcifications: Pathophysiology, etiologies, differential diagnoses, and imaging findings

Nance

Crane

Halushka

et al. 2015

Journal of Cardiovascular Computed Tomography

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“…It thus leads to diastolic dysfunction and even a restrictive physiology in extreme cases. It can also cause focal wall motion abnormalities, 8 and life-threatening arrhythmias if there is calcification in the conduction system. 9 In our patient left ventricular systolic and diastolic dysfunction with restrictive physiology were noted.…”

Section: Discussionmentioning

confidence: 99%

A Case of Extensive Myocardial Calcification

Yusuf

Balqees²,

Hussain³

2022

PAFMJ

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Aortic valve and mitral annular calcification are commonly seen in elderly patients with chronic kidney disease and/ or altered calcium hemostasis. Extensive myocardial calcification is rare. We present a case of an elderly female who presented with sepsis and heart failure on a clinical background of chronic kidney disease and showed extensive myocardial calcification on multi-modality imaging, leading to severe impairment in systolic and diastolic function with restrictive physiology. Conclusion: Myocardial calcification is an under diagnosed entity that leads to considerable morbidity and mortality. Modern imaging methods allow a prompt diagnosis but a high index of suspicion has to be maintained for accurate detection of medical condition.

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Full calcium jacket: massive idiopathic myocardial calcification by cardiovascular magnetic resonance and cardiac CT

Cited by 7 publications

References 0 publications

Prevalence and prognosis of ischaemic and non-ischaemic myocardial fibrosis in older adults

Prevalence and prognosis of ischaemic and non-ischaemic myocardial fibrosis in older adults

Myocardial calcifications: Pathophysiology, etiologies, differential diagnoses, and imaging findings

A Case of Extensive Myocardial Calcification

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