Restrictive cardiomyopathy caused by diffuse calcification of the left ventricle after 20 years of haemodialysis

Cardiovasc J Afr. 2022;33(2):95-97. doi: 10.5830/CVJA-2021-031. Epub 2021 Jul 5.

Abstract

Valvular and vascular calcifications are common among patients with end-stage renal disease, but diffuse calcification of the left ventricle is rarely reported. We report on a rare case of restrictive cardiomyopathy resulting from severe myocardial calcification and review the literature. A 77-year-old man was diagnosed with end-stage renal disease after having received regular haemodialysis for 20 years. He was referred to our emergency room due to exertional dyspnoea and exacerbated shortness of breath. A chest X-ray revealed severe pulmonary oedema and bilateral massive pleural effusion. Transthoracic echocardiography revealed impaired diastolic function of the left ventricle but preserved systolic function with a 50% ejection fraction. Repeat chest computed tomography demonstrated exacerbation of the calcification from the mitral annulus to the whole circular left ventricle. A coronary angiogram revealed non-significant stenosis, and right heart catheterisation demonstrated elevated pulmonary capillary wedge pressure. He was discharged after two weeks of conservative medication.

Keywords: cardiac calcification; heart failure; restrictive cardiomyopathy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Calcinosis* / complications
  • Calcinosis* / diagnostic imaging
  • Cardiomyopathy, Restrictive* / diagnosis
  • Cardiomyopathy, Restrictive* / diagnostic imaging
  • Heart Ventricles / diagnostic imaging
  • Humans
  • Kidney Failure, Chronic* / complications
  • Kidney Failure, Chronic* / diagnosis
  • Kidney Failure, Chronic* / therapy
  • Male
  • Renal Dialysis / adverse effects
  • Ventricular Function, Left