Massive Myocardial Calcification.

BACKGROUND

Massive myocardial calcification is an extremely rare condition with diverse etiologies, often requiring multimodality imaging for diagnosis.

CASE SUMMARY

A 73-year-old woman with coronary artery disease and a history of ovarian carcinoma presented with dizziness and dyspnea. Echocardiography revealed a large floating structure on the anterior mitral leaflet, left ventricular hypertrophy, and extensive myocardial calcification. Preoperative imaging confirmed calcifications, and surgery included decalcification, subvalvular myectomy, and aortic valve replacement. Histology revealed fibrosis and scarring. Four years later, she developed pulmonary hypertension, increased calcification, and right ventricular dysfunction. Despite thorough evaluation, the etiology of the calcification remained unclear, with hypertrophic cardiomyopathy considered a probable underlying condition.

DISCUSSION

This case highlights a rare presentation of myocardial calcification, emphasizing the value of multimodality imaging and comprehensive diagnostic workup. It contributes to the limited literature on the condition and its management challenges.

TAKE-HOME MESSAGES: Multimodality imaging and a systematic approach are vital for diagnosing and managing rare cardiac conditions like massive myocardial calcification.