Extensive Myocardial Calcifications Associated With Recent-Onset Renal Failure and Primary Hyperparathyroidism

Cardiac calcifications are a rare consequence of end-stage renal failure and hyperparathyroidism.

A 35-year-old man with no prior medical history was admitted to our institution with sudden blindness in his right eye and severe renal failure. Ophthalmologic evaluation revealed central retinal artery occlusion with arterial calcifications. End-stage chronic renal failure was diagnosed. A positron emission tomography-computed tomography (CT) and a Tc-99m multiplex ion beam imaging scintigraphy confirmed hyperparathyroidism. Transthoracic echocardiography, magnetic resonance imaging, and cardiac CT identified significant myocardial calcifications and restrictive cardiomyopathy caused by hyperparathyroidism and renal failure. Management included dialysis and parathyroidectomy.

This is the first human report to assess cardiac calcifications associated with hyperparathyroidism and end-stage renal failure with a strong correlation between transthoracic echocardiography, magnetic resonance imaging, and cardiac CT.

Calcium-phosphorus metabolic disorders and renal failure contribute to multiple systemic complications, including vascular disease, cardiomyopathy, and atrial fibrillation.