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Case Reports
. 2021 Apr 1;3(2):e200549.
doi: 10.1148/ryct.2021200549. eCollection 2021 Apr.

Rapid Onset Development of Myocardial Calcifications in the Setting of Renal Failure and Sepsis

Joy Li  1 , Lydia Chelala  1 , Rydhwana Hossain  1 , Jean Jeudy  1 , Charles White  1
Affiliations
Case Reports

Rapid Onset Development of Myocardial Calcifications in the Setting of Renal Failure and Sepsis

Joy Li et al. Radiol Cardiothorac Imaging. .

Abstract

Myocardial calcifications can arise following damage to myocardial tissue or in the setting of disturbances in the calcium and phosphorus balance. They are associated with a number of cardiac sequelae, as well as higher mortality. Three cases of rapid-onset myocardial calcifications that developed within the course of 5 to 13 weeks in patients who had a history of sepsis and renal failure while undergoing hemodialysis are described. Baseline imaging from several weeks prior without myocardial calcification are shown for each of the three patients, demonstrating the rapid onset of these calcifications. The clinical significance of these findings is discussed. © RSNA, 2021.

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Conflict of interest statement

Disclosures of Conflicts of Interest: J.L. disclosed no relevant relationships. L.C. disclosed no relevant relationships. R.H. disclosed no relevant relationships. J.J. disclosed no relevant relationships. C.W. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: author is associate editor of Radiology: Cardiothoracic Imaging; Other relationships: disclosed no relevant relationships.

Figures

Images in a 34-year-old woman with end-stage renal disease and septic shock. A, Prior axial non–contrast-enhanced chest CT scan with no evidence of myocardial calcifications. B, Axial non–contrast-enhanced chest CT scan at similar level acquired 36 days later shows marked calcification in the left ventricular lateral wall, interventricular septum, and right ventricle (arrows).
Figure 1:
Images in a 34-year-old woman with end-stage renal disease and septic shock. A, Prior axial non–contrast-enhanced chest CT scan with no evidence of myocardial calcifications. B, Axial non–contrast-enhanced chest CT scan at similar level acquired 36 days later shows marked calcification in the left ventricular lateral wall, interventricular septum, and right ventricle (arrows).
Images in a 20-year-old man with history of trisomy 21 and recent diagnosis of COVID-19 pneumonia with development of dystrophic myocardial calcifications in the left heart within 5 weeks. A, Axial non–contrast-enhanced chest CT scan with no evidence of myocardial calcifications. B, Axial non–contrast-enhanced chest CT scan obtained 40 days later shows dystrophic deposition of calcium in the left ventricular lateral wall myocardium (arrow).
Figure 2:
Images in a 20-year-old man with history of trisomy 21 and recent diagnosis of COVID-19 pneumonia with development of dystrophic myocardial calcifications in the left heart within 5 weeks. A, Axial non–contrast-enhanced chest CT scan with no evidence of myocardial calcifications. B, Axial non–contrast-enhanced chest CT scan obtained 40 days later shows dystrophic deposition of calcium in the left ventricular lateral wall myocardium (arrow).
Images in a 30-year-old man with end-stage renal disease who developed dystrophic myocardial calcifications in the left heart within 13 weeks. A, Prior axial non–contrast-enhanced chest CT scan with absence of myocardial calcifications. B, Axial non–contrast-enhanced chest CT scan acquired 93 days later shows interval development of calcium deposition within the lateral wall of the left ventricle and papillary muscle (arrows). C, Dual-energy CT scan with calcium-suppression demonstrates low attenuation confirming the presence of calcium deposition in the left ventricle and papillary muscle (arrows).
Figure 3:
Images in a 30-year-old man with end-stage renal disease who developed dystrophic myocardial calcifications in the left heart within 13 weeks. A, Prior axial non–contrast-enhanced chest CT scan with absence of myocardial calcifications. B, Axial non–contrast-enhanced chest CT scan acquired 93 days later shows interval development of calcium deposition within the lateral wall of the left ventricle and papillary muscle (arrows). C, Dual-energy CT scan with calcium-suppression demonstrates low attenuation confirming the presence of calcium deposition in the left ventricle and papillary muscle (arrows).
See this image and copyright information in PMC

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