CTICasesDiffuse Myocardial Calcification Secondary to Sepsis
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Imaging findings
Sequential CT scans demonstrate the rapid onset and progression of extensive, diffuse myocardial calcification over a two-to-four-week period. The initial CT shows a normal-appearing myocardium, but subsequent scans reveal progressive, dense calcification throughout the entire ventricular wall and focal areas of lung parenchymal calcification.
Key takeaways
Diffuse myocardial calcification, sometimes referred to as 'heart of stone,' is a rare but catastrophic phenomenon that can occur in the setting of severe sepsis, profound hypotension, and acute kidney injury. It is hypothesized that severe hypoxia and hypoperfusion trigger rapid myocardial necrosis, with subsequent dystrophic calcification of the necrotic cardiac myocytes. While frequently fatal, some patients survive with variable recovery of cardiac function.
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