PMC8523104_01
The electrocardiogram showed normal sinus rhythm, first-degree AV block, and T-wave inversion in the inferolateral leads.
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His electrocardiogram (ECG) showed a normal sinus rhythm, first degree atrioventricular (AV) block, and T wave inversion in the inferolateral leads suggestive of myocardial ischemia (Figure 1).
The axial image of low-dose CT during MPI demonstrated a significant amount of calcification at mitral valvular annulus, LV myocardium at septum, and free wall as well as pericardium (white arrows). [LA = left atrium; LV = left ventricle; RA = right atrium; LV = left ventricle.]
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His MPI demonstrated mildly decreased LV ejection fraction of 49% without evidence of myocardial ischemia or infarction; however, significant LV calcification (Figure 2) was observed on the low-dose CT used for attenuation correction during MPI.
The posteroanterior (left) and lateral (right) views of patient's chest x-ray.
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The chest x-ray (Figure 3) showed extensive cardiac calcification, and the echocardiogram (Figure 4) revealed significant calcification of mitral valve annulus, LV septum, and mid free wall.
The parasternal view (left) and 4-chamber view of echocardiogram (right) showed calcification of mitral annulus, LV septum, and free wall (indicated by white arrows). [LA = left atrium; LV = left ventricle; RA = right atrium; LV = left ventricle.]
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The chest x-ray (Figure 3) showed extensive cardiac calcification, and the echocardiogram (Figure 4) revealed significant calcification of mitral valve annulus, LV septum, and mid free wall. His echocardiography showed: (1) normal LV systolic function with calcification in the LV septum, mid free wall and mitral valve annulus (Figure 4) and normal right ventricular (RV) size and systolic function; (2) moderate bi-atrial enlargement with mild mitral regurgitation, moderate tricuspid regurgitation; and (3) severe pulmonary hypertension and LV diastolic dysfunction.
The sagittal (upper left), axial (upper right), and coronal images (lower left and right) of the chest CT demonstrated calcification of LV myocardium, mitral valve annulus (* in upper left image), and pericardium (white arrows in upper and lower left images) over the LV. [LA = left atrium; LV = left ventricle; RA = right atrium; LV = left ventricle.]
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However, his chest CT (Figure 5) revealed massive myocardial calcification involving only LV and its overlaying pericardium.