Rapidly progressive myocardial calcification following sepsis

Yoshihara, Shu; Yaegashi, Taku; Matsunaga, Masaki; Naito, Masaaki

doi:10.1016/j.jccase.2021.08.011

Cited by 5 publications

(7 citation statements)

References 10 publications

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“…As he had biventricular dysfunction, it was considered that the myocardium was diffusely damaged in both ventricles; nonetheless, severe calcification was localized in the LV, with only mild calcification observed in the RV. In other reports with myocardial calcification resulting from myocarditis or sepsis, severe calcification frequently occurred only in the LV, as in the current case ( 1 , 3 ). It has been noted that calcification of the RV owing to pulmonary hypertension (PH) may be a variant of RV remodeling ( 7 ), implying that RV calcification may be linked to RV afterload.…”

Section: Discussionsupporting

confidence: 77%

“…Myocardial calcification is categorized as either metastatic or dystrophic ( 1 ). Metastatic calcification results from a systemic process (hypercalcemia and/or abnormalities of calcium homeostasis) in patients with chronic renal failure on hemodialysis, primary or secondary hyperparathyroidism, and dietary calcium and vitamin D deficiency ( 3 ). However, dystrophic calcification occurs where necrosis or damage to myocardial cells has occurred, such as in myocardial infarction, cardiac surgery, or systemic disorders, such as sepsis, irrespective of serum calcium concentration ( 1 , 2 ).…”

Section: Discussionmentioning

confidence: 99%

“…Various reports have demonstrated that myocardial calcification occurs in the acute to subacute phase from a few days to a few months following myocardial injury ( 3 - 5 ). Because it tends to be discovered incidentally on CT or echocardiography in most cases ( 4 ), a clear time course of calcification occurrence has not been determined.…”

Section: Discussionmentioning

confidence: 99%

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An Autopsy Case of Fulminant Myocarditis with Massive Left Ventricular Calcification

Yagi-Nakajima,

Miura,

Sawada

et al. 2024

Intern. Med.

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Myocardial calcification in myocarditis is rare and may be linked to poor outcomes. We herein report a case of fulminant myocarditis with massive myocardial calcification and its pathological outcomes at autopsy. A 49-year-old man experienced chest pain and was diagnosed with acute myocarditis. His cardiac function did not recover despite mechanical circulatory support in combination with V-A extracorporeal membrane oxygenation and IMPELLA CP Ⓡ . He eventually developed sepsis and gastrointestinal bleeding and died on day 27. Diffuse myocardial calcification was observed on computed tomography at autopsy. The pathological autopsy depicted that calcification filled every myocardial cell in the left ventricle.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

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An Autopsy Case of Fulminant Myocarditis with Massive Left Ventricular Calcification

Yagi-Nakajima,

Miura,

Sawada

et al. 2024

Intern. Med.

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“…Dystrophic calcification, on the other hand, refers to the deposition of calcium salts in damaged or necrotic tissues in the absence of deranged calcium metabolism (1 -5). In the context of dystrophic calcification, the precipitating tissue damage can occur secondary to various clinical conditions including sepsis, myocardial infarction, radiation therapy, anatomic cardiac abnormalities, especially anomalies of the coronary arteries, and other factors leading to myocardial ischemia (1 -10).…”

Section: Discussionmentioning

confidence: 99%

“…While the literature does lay bare that ischemic injury is the only substrate required to precipitate the phenomenon of extensive myocardial calcification, he was hospitalized and clinically septic secondary to various infections for nearly two months prior to his demise. A number of studies have documented myocardial calcification as a rare complication of severe sepsis, and in this context extensive myocardial calcification can appear in as little as 4 to 6 weeks (5 -8). As this complication is much rarer than sepsis, itself, some studies have attempted to identify the circumstances under which extensive myocardial calcification is more likely to present.…”

Section: Discussionmentioning

confidence: 99%

Myocardial Calcification: An Unusual Complication of Remote Trauma With Coidentified Amyloidosis

Wilkinson,

Krywanczyk

2023

Academic Forensic Pathology

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We present the heart of a 38-year-old man with paraplegia due to a remote traumatic spinal cord injury. In the 20 years following his injury, he experienced chronic decubitus ulcers, osteomyelitis, neurogenic bladder, malnutrition, and urinary tract infections. He was admitted to the hospital with septic shock secondary to multiple decubitus ulcers and osteomyelitis and expired after a two-month hospitalization. At autopsy, there was marked replacement of left ventricle and interventricular septal myocardium by gritty, firm, yellow-white tissue. Microscopic examination demonstrated a remote infarct with marked dystrophic calcification and unexpected amyloid deposition. This example demonstrates the extraordinary extent to which dystrophic calcifications can replace myocardium and highlights multiple potential etiologies of myocardial calcifications. Of note, this is the first report documenting myocardial calcification as a complication of remote, non-iatrogenic trauma. The role of the amyloidosis in the development of calcification is unclear, but a contributory effect cannot be excluded.

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Ultra-early myocardial calcification secondary to fulminant myocarditis with 4 years of follow-up: a case report

You

Zeng

Wang

2023

European Heart Journal - Case Reports

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Background Early myocardial calcifications secondary to fulminant myocarditis (FM) are rare, and their natural evolution and effects on cardiac function are poorly understood. Here, we followed the patient for 4 years to observe the development of cardiac calcification and its impact on heart function. Case summary A 16-year-old man was hospitalized with a fever and cough for 1 day. The patient was previously healthy and had no history of heart disease or specific family conditions. The patient was positive for anti-Epstein–Barr virus IgG and IgM. The computed tomography (CT) scan showed no coronary lesions. Cardiogenic shock and recurrent ventricular fibrillation developed on the third day after admission, and the patient received rescue therapy such as endotracheal intubation, defibrillation, extracorporeal membrane oxygenation, and corticosteroids. On the 13th day of admission, a CT scan revealed significant calcification in the left ventricular wall. The patient was discharged after 30 days in the hospital. After discharge, his left ventricular calcification peaked at 6 months and gradually subsided after that, and his left ventricular function slowly returned to normal at 12 months. Discussion In younger patients, myocardial calcifications secondary to FM may occur as early as 13 days and affect cardiac function. After proper treatment and rehabilitation, the patient’s myocardial calcification can gradually subside and the cardiac function can gradually recover. For FM patients, timely and comprehensive intensive treatment, including heart, lung, and kidney replacement therapy and early administration of hormone preparations, may be beneficial to the early recovery of patients.

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Rapidly progressive myocardial calcification following sepsis

Cited by 5 publications

References 10 publications

An Autopsy Case of Fulminant Myocarditis with Massive Left Ventricular Calcification

An Autopsy Case of Fulminant Myocarditis with Massive Left Ventricular Calcification

Myocardial Calcification: An Unusual Complication of Remote Trauma With Coidentified Amyloidosis

Ultra-early myocardial calcification secondary to fulminant myocarditis with 4 years of follow-up: a case report

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