statdx/docs_md/articles/cardiac-calcifications_c53ad786-4464-4a04-a3e9-ccd286e1f8fc.md

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Cardiac Calcifications	c53ad786-4464-4a04-a3e9-ccd286e1f8fc	key value df804626-c042-4296-96e3-836a6da50fd6 Gregory Kicska, MD, PhD	name slug treeNodeId Cardiac cardiac fa90100b-619c-430e-8074-b5b9789bab39 name slug treeNodeId Differential Diagnosis differential-diagnosis 952326a0-b3ea-4a21-aa7a-d796cc9325ed name slug treeNodeId Cardiac Calcifications cardiac-calcifications null	Cardiac	76a1cfbf-a803-4de9-be9e-02798943ac36	9	03/17/22	Cardiac Calcifications	Cardiac, Differential Diagnosis, Cardiac Calcifications	Cardiac Calcifications | STATdx	Cardiac Calcifications	DDX	Cardiac Differential Diagnosis Cardiac Calcifications

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title: "Cardiac Calcifications" docid: "c53ad786-4464-4a04-a3e9-ccd286e1f8fc" authors:

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ESSENTIAL INFORMATION

• Key Differential Diagnosis Issues

  • Most common pitfall is misidentifying which anatomic structure is calcified
  • Cardiac calcifications more common in dialysis patients

• Helpful Clues for Common Diagnoses

  • Coronary Artery - Curvilinear, parallel lines most commonly in proximal coronary arteries and at vessel branch points - Amount of calcium correlates with amount of coronary plaque but not degree of stenosis - Presence correlates with risk of future cardiac events
  • Mitral Valve - Annular calcifications - Associated with mitral valve insufficiency - Valvular calcifications - Suggests stenosis, most often due to rheumatic heart disease
  • Aortic Valve - Calcification burden correlates with stenosis severity - Bicuspid valve - Young patients - Coexistent coarctation - Degenerative - Patients > 60 years of age - Risk factor for coronary atherosclerosis - Rheumatic heart disease - Patients > 35 years of age - Coexistent mitral valve stenosis

• Helpful Clues for Less Common Diagnoses

  • Pericardial - Associated with constrictive pericarditis
  • Myocardial - Indicates prior infarction; myocardial fat will likely be present
  • Other Cardiac Valves and Chambers - Tricuspid valve - Most commonly due to rheumatic heart disease; mitral and aortic valve will likely be calcified - Pulmonary valve - Most commonly due to congenital pulmonary stenosis - Atrial calcifications - Associated with severe atrial dilation

• Helpful Clues for Rare Diagnoses

  • Mass - Chronic thrombus - Atrial appendage or adjacent to infarcted myocardium - Metastasis - History of primary tumor - Atrial myxoma - Look for characteristic location and attachment

Images

Selected Images

Coronary Arteries Axial oblique CECT MIP shows discrete calcifications in a linear arrangement in a patient with LAD atherosclerosis. Note the presence of noncalcified plaque .

Coronary Arteries Axial oblique CECT MIP shows discrete calcifications in a linear arrangement in a patient with LAD atherosclerosis. Note the presence of noncalcified plaque .

Mitral Valve Leaflets Frontal radiograph shows characteristic reversed C-shaped calcification indicating mitral valve annular calcification. This calcification pattern is very common and, unlike leaflet calcification, not usually associated with stenosis.

Mitral Valve Leaflets Axial NECT shows mitral valve leaflet calcifications in a patient with mitral stenosis presumed to be due to rheumatic heart disease. Note the enlarged left atrium and left atrial calcifications . The patient also has aortic stenosis and calcifications .

Aortic Valve Double oblique CECT MIP shows dense calcifications of the aortic valve cusps in a patient with severe aortic stenosis. Calcium burden correlates with severity of stenosis.

Pericardial Axial NECT shows pericardial calcification at the atrioventricular grooves. Note the epicardial fat to differentiate from coronary calcium.

Myocardial Left ventricular outflow view shows apical calcification and wall thinning in a patient with prior myocardial infarction. Note the epicardial fat to differentiate from pericardium . Wall motion abnormality was present (not shown).

Neoplastic Mass Axial NECT (left) and bright blood MR (right) show a new calcification in the RV of a 40-year-old patient with remote history of pulmonary embolus. This calcification corresponded to the presence of a chronic thrombus .

Neoplastic Mass Lateral radiograph shows curvilinear calcification in the left atrium in a patient with left atrial myxoma.

Additional Images

Mitral Valve Leaflets Four-chamber CECT shows both papillary muscle and mitral valve annular calcification. Papillary muscle calcification is commonly seen in dialysis patients.