CTICasesHeart of Stone
Imaging findings
Contrast-enhanced and non-contrast chest CT in a young patient on ECMO and dialysis with lymphocytic myocarditis and acute renal failure shows severe, diffuse myocardial calcification of the left ventricle. Non-contrast CT obtained 13 days later confirms that the dense myocardial appearance is due to true calcium deposition rather than delayed contrast retention.
Key takeaways
"Heart of stone" refers to rapid, diffuse myocardial calcification, typically occurring in the setting of severe myocardial injury (e.g., myocarditis) coupled with renal failure and calcium-phosphate imbalance (metastatic calcification). It can develop in as little as 2 days and should not be mistaken for prolonged interstitial retention of iodinated contrast.
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