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Case Reports
. 2019 Apr 14:2019:6707690.
doi: 10.1155/2019/6707690. eCollection 2019.

Caseous Intracardiac Calcification: A Diagnostic Enigma

Simon G Findlay  1 , Nicholas M Child  1 , Douglas F Muir  2
Affiliations
Case Reports

Caseous Intracardiac Calcification: A Diagnostic Enigma

Simon G Findlay et al. Case Rep Cardiol. .

Abstract

Intramyocardial calcification is a rare phenomenon often only discovered on postmortem. We describe the case of a healthy 69-year-old lady diagnosed with idiopathic caseous intracardiac calcification extending from the mitral valve annulus. We present high-quality images and propose an investigatory template for future cases.

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Figures

Figure 1
Figure 1
Computed tomography ((a) multiplanar reformatted (MPR) and (b) maximal intensity projection (MIP)) demonstrated extensive infiltrative calcification, circumferentially around the mitral annulus, extending posteriorly and septally into the myocardial apex. RA: right atrium; RV: right ventricle; LA: left atrium; LV: left ventricle.
Figure 2
Figure 2
(a) Magnetic resonance T1-weighted spin echo demonstrating multiple low signal lesions throughout the left ventricular myocardium (∗), consistent with extensive infiltrative calcification of the myocardium. (b) Magnetic resonance phase-sensitive inversion recovery late gadolinium enhancement demonstrating a heterogenous composition to the intramyocardial lesions within the nulled myocardium (^), suggestive of caseating calcification within the myocardium (four-chamber view Siemens Avanto 1.5 Tesla).
Figure 3
Figure 3
Coronary angiography illustrating the absence of significant obstructive coronary artery disease and highlighting extensive myocardial calcification (∗), particularly prominent around the mitral valve annulus: (a) left anterior oblique view and (b) right anterior oblique view. RCA: right coronary artery; LCx: left circumflex artery; LAD: left anterior descending artery.
See this image and copyright information in PMC

References

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