Calcificación miocárdica metastásica: diagnóstico por imagen multimodalidad
Maria Antonia Mesa-Maya1, Luisa Fernanda Durango-Gutiérrez2, María Isabel Carvajal-Vélez3
1Universidad CES, Medellín, Colombia.
JACC. Case reports
|January 14, 2026
Resumen
La calcificación miocárdica metastásica (CMM) puede imitar la amiloidosis cardíaca en la RMN. La imagen multimodalidad es crucial para diagnosticar esta rara complicación de la enfermedad renal crónica en pacientes en diálisis.
Área de la Ciencia:
- Cardiología
- Nefrología
- Radiología
Sus antecedentes:
- La calcificación miocárdica metastásica (CMM) es una complicación rara de la enfermedad renal crónica-trastorno mineral óseo (CKD-MBD).
- La CMM puede confundirse con miocardiopatías infiltrativas en la imagen cardíaca.
- El hiperparatiroidismo secundario es una comorbilidad común.
Objetivo del estudio:
- Destacar las características de imagen de la CMM.
- Enfatizar la importancia de la imagen multimodalidad en la diferenciación de la CMM de otras miocardiopatías infiltrativas.
- Aumentar la concienciación sobre la CMM en pacientes en diálisis con hiperparatiroidismo secundario.
Principales métodos:
- Informe de caso de una mujer de 30 años en diálisis peritoneal con nefropatía por IgA.
- Se utilizó ecocardiografía, RMN cardíaca y TC sin contraste.
- Se realizó angiografía coronaria.
Principales resultados:
- El paciente se presentó con dolor torácico, troponina elevada e hipertensión severa.
- La RMN cardíaca mostró hallazgos preocupantes de amiloidosis pero con características atípicas (reducción de T1 nativo).
- La TC sin contraste confirmó la hiperatenuación miocárdica difusa, indicativa de CMM.
Conclusiones:
- La CMM puede imitar de cerca la amiloidosis en la RMN cardíaca.
- La imagen multimodalidad es esencial para el diagnóstico preciso de la CMM.
- Se debe considerar la CMM en pacientes en diálisis con hiperparatiroidismo secundario.
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