Babady Mehran, Maltsinioti Charalampia, Limaj Ermal, Bruder Oliver, Karamarkou Christina
Department of Cardiology and Angiology, Elisabeth Hospital Essen, Essen, Germany.
Department of Cardiology and Angiology, Elisabeth Hospital Essen, Essen, Germany.
JACC Case Rep. 2025 Apr 2;30(7):103384. doi: 10.1016/j.jaccas.2025.103384.
Massive myocardial calcification is an extremely rare condition with diverse etiologies, often requiring multimodality imaging for diagnosis.
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.
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.
大面积心肌钙化是一种极其罕见的病症，病因多样，通常需要多模态成像进行诊断。
一名73岁患有冠状动脉疾病且有卵巢癌病史的女性出现头晕和呼吸困难。超声心动图显示二尖瓣前叶有一个大的漂浮结构、左心室肥厚以及广泛的心肌钙化。术前成像证实了钙化情况，手术包括去钙化、瓣下肌切除术和主动脉瓣置换术。组织学检查显示有纤维化和瘢痕形成。四年后，她出现了肺动脉高压、钙化增加以及右心室功能障碍。尽管进行了全面评估，但钙化的病因仍不明确，肥厚型心肌病被认为是可能的潜在病因。
该病例突出了心肌钙化的罕见表现，强调了多模态成像和全面诊断检查的价值。它为关于该病症及其管理挑战的有限文献做出了贡献。
多模态成像和系统方法对于诊断和管理像大面积心肌钙化这样的罕见心脏病症至关重要。
