MyPACS.net: Radiology Teaching Files > Case 9886697

previously visited PERICARDIAL CALCIFICATIONS
Contributed by: Bharathi Batchu, Radiologist, Newark Beth Israel, New Jersey, USA.
Patient: 48 year old male
History: 48 y male with chest pain.
Images:[small]larger

Fig. 1: Chest xray frontal view

Fig. 2: Lateral view chest xray

Fig. 3: CT chest axial image

Fig. 4: CT chest axial image

Fig. 5: CT chest coronal image
Findings: Frontal and lateral views of the chest show a large calcified plaque along the diaphragmatic/ inferior aspect of the cardiac silhouette. It follows the expected course of the pericardium.

A Chest CT with IV contrast confirms coarse calcifications in the pericardium.
Discussion: Pericardial calcifications usually occur along the inferior/ diaphragmatic surface of the pericardium surrounding the ventricles. Viral infection or uremia cause thin egg-shell like calcification. Tuberculosis causes irregular coarse calcifications. Myocardial calcifications post myocardial infarction are usually curvilinear and are seen along the anterolateral wall of the LV or LV apex.

They must be differentiated from coronary arterial calcifications, myocardial calcifications, diaphragmatic calcifications and valvular calcifications.

Pericardial calcifications are nonspecific for diagnosis of constrictive pericarditis. Constrictive pericarditis is present when a thick fibrotic pericardium interferes with diastolic filling of the heart. This results in elevated systemic venous pressure, pulmonary congestion and reduced cardiac output.
References: Cardiac calcifications. Emedicine.
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Additional Details:

Case Number: 9886697Last Updated: 08-05-2007
Anatomy: Heart   Pathology: Other
Modality: CT, Conventional RadiographAccess Level: Readable by all users
Keywords: pericardial calcifications

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