Septic myocardial calcification: A case report

Aniello Maiese1, Federico Manetti2, Raffaele La Russa1

  • 1Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University of Rome, Viale Regina Elena 336, 00161, Italy; IRCCS Neuromed, Via Atinense 18, Pozzilli, 86077, Italy.

Insights

This study reports a rare case of myocardial calcification in a patient with sepsis. Histological examination revealed extensive calcification in the right atrial wall, highlighting a potential complication of severe sepsis.

Area of Science:

  • Pathology
  • Cardiology
  • Infectious Diseases

Background:

  • Sepsis can lead to various cardiac histological changes, including myocytolysis and fibrosis.
  • Septic myocardial calcification is an exceedingly rare condition with unclear pathogenesis.
  • Existing knowledge on myocardial calcification primarily recognizes metastatic or dystrophic mechanisms.

Observation:

  • A 72-year-old male with polytrauma developed sepsis on day 110.
  • Transesophageal echocardiogram identified right atrial wall calcification; no predisposing systemic factors were noted.
  • The patient died from septic shock and multi-organ failure on day 149.

Findings:

  • Autopsy confirmed a calcified, firm right atrial wall with a greenish-brown formation.
  • Histological examination revealed extensive subendocardial calcification with fibrin deposition and surrounding fibrosis.

Implications:

  • This case expands the understanding of rare cardiac manifestations of severe sepsis.
  • It underscores the importance of considering myocardial calcification in sepsis survivors with cardiac abnormalities.
  • Further research into the specific mechanisms of sepsis-induced myocardial calcification is warranted.

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