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Calcific left atrium: A rare consequence of endocarditis
Giuseppe Dattilo1, Carmelo Anfuso1, Matteo Casale1
1Giuseppe Dattilo, Matteo Casale, Vincenza Giugno, Lorenzo Camarda, Natascia Laganà, Gianluca Di Bella, Department of Clinical and Experimental Medicine, Section of Cardiology, University of Messina, 98125 Messina, Italy.
Insights
Unusual atrial wall calcifications were identified in a patient with dyspnea. Advanced imaging confirmed the findings, suggesting an infective endocarditis etiology.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Cardiac calcifications are common in valves and annuli, but atrial wall calcifications are rare.
- High-resolution imaging modalities like cardiac MRI and CT are necessary for detecting unusual cardiac calcifications.
Observation:
- A 43-year-old patient presented with mild dyspnea and was found to have a calcific aortic valve and an atrioventricular plane lesion.
- Cardiac magnetic resonance (CMR) and computed tomography (CT) were used to further characterize the lesion's location.
Findings:
- The imaging findings and lesion location suggested an infective etiology, likely endocarditis affecting the aortic valve, atrioventricular plane, and left atrium.
- Despite the suspected diagnosis, the patient showed no clinical or echocardiographic worsening over a 12-month follow-up.
Implications:
- Cardiac MRI and CT are crucial for diagnosing and monitoring patients with atypical cardiac calcific degeneration.
- This case highlights the importance of advanced imaging in identifying rare cardiac pathologies.
Abstract:
Usually, cardiac calcifications are observed in aortic and mitral valves, atrio-ventricular plane, mitral annulus, coronary arteries, pericaridium (usually causing constrictive pericarditis) and cardiac masses. Calcifications of atrial walls are unusual findings that can be identified only using imaging with high spatial resolution, such as cardiac magnetic resonance and computed tomography. We report a case of a 43-year-old patient with no history of heart disease that underwent cardiac evaluation for mild dyspnoea. The echocardiogram showed a calcific aortic valve and a hyper-echogenic lesion located in atrio-ventricular plane. The patient was submitted to cardiac magnetic resonance and to computed tomography imaging to better characterize the localization of mass. The clinical features and location of calcified lesion suggest an infective aetiology causing an endocarditis involving the aortic valve, atrio-ventricular plane and left atrium. Although we haven't data to support a definite and clear diagnosis, the clinical features and location of the calcified lesion suggest an infective aetiology causing an endocarditis involving the aortic valve, atrio-ventricular plane and left atrium. The patient was followed for 12 mo both clinically and by electrocardiogram and echocardiography without worsening of clinical, electrocardiographic and echocardiographic data. Cardiac magnetic resonance imaging and computed tomography are ideal methods for identifying and following over time patients with calcific degeneration in the heart.
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