Reversible Myocardial Calcification Following Acute Heart Failure and Kidney Injury Caused by Valsalva Sinus Rupture
DOI:
https://doi.org/10.1532/hsf.4759Keywords:
Valsalva Sinus Rupture, Myocardial Calcification, Acute Heart FailureAbstract
A 47-year-old previously healthy man was referred to a local hospital with chest tightness, oliguria, and lower extremity edema for seven days. An initial investigation revealed acute heart failure and kidney injury. The patient was intensively treated with cardiac and renal replacement therapy, and cardiorenal function improved one week later. Two months later, echocardiography was performed because chest tightness and edema had not resolved. Echocardiography showed Valsalva sinus rupture, and the patient was transferred to our center. Myocardial calcification was observed in the left ventricular wall on computed tomography after admission. The patient underwent cardiac surgery and recovered smoothly. At the three-year follow up, the patient was asymptomatic with normal renal function and serum electrolytes. Imaging revealed a significant reduction in diffuse calcification of the left ventricular wall. This case indicates that this rare form of reversible myocardial calcification may be associated with acute heart and renal failure caused by Valsalva sinus rupture. The results of this case will guide clinicians about further management and timely referral of such patients to appropriate specialties.
References
Ananthakrishna R, Moorthy N. 2016. Dystrophic myocardial calcification. Indian Heart J. 68 Suppl 2: S180-S181.
Gowda RM, Boxt LM. 2004. Calcifications of the heart. Radiol Clin North Am. 42(3):603-17, vi-vii.
Jing J, Kawashima A, Sickler K, Raval BK, Oldham SA. 1998. Metastatic cardiac calcification in a patient with chronic renal failure who was undergoing hemodialysis: radiographic and CT findings. AJR Am J Roentgenol. 170(4):903-5.
Kapandji N, Redheuil A, Fouret P, et al. 2018. Extensive Myocardial Calcification in Critically Ill Patients. Crit Care Med. 46(7): e702-e706.
Kimura Y, Seguchi O, K KA, et al. 2019.Massive Biventricular Myocardial Calcification in a Patient with Fulminant Myocarditis Requiring Ventricular Assist Device Support. Intern Med. 58(9):1283-1286.
Kuzela DC, Huffer WE, Conger JD, Winter SD, Hammond WS. 1977. Soft tissue calcification in chronic dialysis patients. Am J Pathol. 86(2):403-24.
Lasser A. Calcification of the myocardium. 1983. Hum Pathol. 14(9):824-6.
Lee HU, Youn HJ, Shim BJ, et al. 2012. Porcelain heart: rapid progression of cardiac calcification in a patient with hemodialysis. J Cardiovasc Ultrasound. 20(4):193-6.
Li J, Chelala L, Hossain R, Jeudy J, White C. 2021. Rapid Onset Development of Myocardial Calcifications in the Setting of Renal Failure and Sepsis. Radiol Cardiothorac Imaging. 3(2):e200549.
Nance JJ, Crane GM, Halushka MK, Fishman EK, Zimmerman SL. 2015.Myocardial calcifications: pathophysiology, etiologies, differential diagnoses, and imaging findings. J Cardiovasc Comput Tomogr. 9(1):58-67.
Schellhammer F, Ansen S, Arnold G, Brochhagen HG, Lackner K. 2002. Myocardial calcification following septic shock. Cardiology. 98(1-2):102-3.
Wada A, Nakata T, Tsuchihashi K, et al. 1993. Massive myocardial calcification of right and left ventricles following acute myocarditis complicated with rhabdomyolysis-induced acute renal failure. Jpn Circ J. 57(6):567-72.
Zakouta R, Carmo Perloirob MD, Freitasc P. 2013. Reversible Myocardial Calcification Following Severe Leptospirosis Complicated with Rhabdomyolysis-Induced Acute Kidney Injury and Magnesium-Wasting Nephropathy. J Med Cases. 4(2):92-97.
