Radiology Teaching Files > Case 9886697

Contributed by: Bharathi Batchu, Radiologist, Newark Beth Israel, New Jersey, USA.
Patient: 48 year old male
History: 48 y male with chest pain.

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.
No comments posted.
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

The reader is fully responsible for confirming the accuracy of this content.
Text and images may be copyrighted by the case author or institution.
You can help keep MyPACS tidy: if you notice a case which is not useful (e.g. a test case) or inaccurate, please contact us.