case_images: PMC10784611_01
case_images: (A) Chest X-ray showing opacity in cardiac silhouette raising suspicion of calcification of mediastinal structure; 2-dimensional-echocardiogram in parasternal long axis (B), apical 4-chamber (C) and parasternal short axis (D) views showing extensive anterolateral (arrow) and posteromedial (arrowhead) papillary muscle with severe endocardial (D) calcification having acoustic shadow; Cardiac computed tomogram in coronal (E), sagittal (F) and axial (G) view showing extensive anterolateral (arrow) and posteromedial (arrowhead) papillary muscle with severe endocardial (D) calcification.
case_images: kcj-54-59-g001.jpg
case_images: PMC10784611_01_kcj-54-59-g001.jpg
case_images: F1
case_images: Chest X-ray revealed a suspicious area of patchy calcification in the cardiac silhouette (Figure 1A). III diastolic dysfunction, severe right ventricular dysfunction, and moderate mitral and tricuspid regurgitation with severe pulmonary hypertension. Interestingly mid and basal portions of the anterior and anterolateral walls as well as both of the papillary muscles were severely calcified which showed acoustic shadowing in echocardiography (Figure 1B-D, Supplementary Videos 1, 2, 3, 4). Cardiac computed tomography revealed significant calcification of corresponding segments with extensive calcification of both the papillary muscles (Figures 1E-G, 2, and 3).
case_images: Volume rendering image showing extensive myocardial calcification (note that calcification is restricted to left coronary territory without affecting right coronary territory). Note the stump of left main coronary artery which was ligated during surgery (arrowhead). Asterix: myocardial calcification with likely both papillary muscles calcification.. LAD = left anterior descending artery; LIMA = left internal mammary artery; RCA = right coronary artery.
case_images: kcj-54-59-g002.jpg
case_images: PMC10784611_01_kcj-54-59-g002.jpg
case_images: F2
case_images: III diastolic dysfunction, severe right ventricular dysfunction, and moderate mitral and tricuspid regurgitation with severe pulmonary hypertension. Interestingly mid and basal portions of the anterior and anterolateral walls as well as both of the papillary muscles were severely calcified which showed acoustic shadowing in echocardiography (Figure 1B-D, Supplementary Videos 1, 2, 3, 4). Cardiac computed tomography revealed significant calcification of corresponding segments with extensive calcification of both the papillary muscles (Figures 1E-G, 2, and 3).
case_images: Cinematic rendering of the heart with window level adjusted for high attenuation structures showing dense calcifications in the left ventricle. White colour: calcification.
case_images: kcj-54-59-g003.jpg
case_images: PMC10784611_01_kcj-54-59-g003.jpg
case_images: F3
case_images: III diastolic dysfunction, severe right ventricular dysfunction, and moderate mitral and tricuspid regurgitation with severe pulmonary hypertension. Interestingly mid and basal portions of the anterior and anterolateral walls as well as both of the papillary muscles were severely calcified which showed acoustic shadowing in echocardiography (Figure 1B-D, Supplementary Videos 1, 2, 3, 4). Cardiac computed tomography revealed significant calcification of corresponding segments with extensive calcification of both the papillary muscles (Figures 1E-G, 2, and 3).