Metastatic cardiac calcification in a patient with chronic renal failure who was undergoing hemodialysis : Radiographic and CT findings

M etastatic calcification, the depositK)fl of calcium in previously normal tissue, is the result of abnormal serum levels of calcium and phosphorus. This tissue calcifIcation is common in patients with chronic renal failure, especially those who have undergone maintenance dialysis [l-4J. The calcifIcation has been attributed to high serum values of either calcium. phosphorus, parathormone, or a combination of these I l-5J. Metastatic cardiac calcification is found at autopsy in most patients who have undergone dialysis, occuring in up to 58% of cases [21. Clinically, cardiac calcification can be suspected in dialyzed patients with unexplained cardiac failure and conduction abnormalities: however, it is not evident radiographically. The incidence of premortem diagnosis of myocardial calcification has not been reported. We present serial radiographic and CT findings of marked myocardial calcification in a 29-year-old woman with chronic renal failure who had undergone hemodialysis for 8 years. The patient had presented with multiple episodes of cardiac failure. To the best of our knowledge. this is the first report in the radiology literature of metastatic cardiac calcification revealed by CT.