Massive idiopathic myocardial calcification presenting with a restrictive cardiomyopathy phenotype: diagnostic challenges in the differential diagnosis of constrictive pericarditis
- 1Medical University of Varna
Abstract
Myocardial calcification is a rare pathological finding that, when extensive myocardial involvement is present, may lead to the development of restrictive cardiomyopathy and progressive heart failure. We report the case of a 57-year-old woman with long-standing heart failure and a restrictive cardiomyopathy phenotype of unknown etiology. Imaging studies demonstrated massive calcium deposits within the left ventricular myocardium and the interventricular septum. Computed tomography initially suggested constrictive pericarditis; however, subsequent echocardiographic assessment and cardiac magnetic resonance imaging supported the diagnosis of restrictive cardiomyopathy secondary to advanced myocardial fibrocalcinosis. No abnormalities of calcium-phosphate metabolism, chronic kidney disease, coronary artery disease, or any other convincing cause of dystrophic or metastatic calcification were identified. Following an extensive differential diagnostic evaluation, a diagnosis of idiopathic massive myocardial calcification was established. This case illustrates the considerable diagnostic challenges in differentiating restrictive cardiomyopathy from constrictive pericarditis and highlights the pivotal role of a multimodality imaging approach in achieving the correct diagnosis.
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BibTeX
@article{chalakova2026massive,
title = {{Massive idiopathic myocardial calcification presenting with a restrictive cardiomyopathy phenotype: diagnostic challenges in the differential diagnosis of constrictive pericarditis}},
author = {T. Chalakova},
journal = {Българска кардиология},
year = {2026},
month = oct,
doi = {10.3897/bgcardio.32.e203572},
url = {https://doi.org/10.3897/bgcardio.32.e203572},
note = {CC BY},
}
RIS
TY - JOUR
TI - Massive idiopathic myocardial calcification presenting with a restrictive cardiomyopathy phenotype: diagnostic challenges in the differential diagnosis of constrictive pericarditis
AU - T. Chalakova
PY - 2026
DA - 2026/10/01
JO - Българска кардиология
DO - 10.3897/bgcardio.32.e203572
UR - https://doi.org/10.3897/bgcardio.32.e203572
AB - Myocardial calcification is a rare pathological finding that, when extensive myocardial involvement is present, may lead to the development of restrictive cardiomyopathy and progressive heart failure. We report the case of a 57-year-old woman with long-standing heart failure and a restrictive cardiomyopathy phenotype of unknown etiology. Imaging studies demonstrated massive calcium deposits within the left ventricular myocardium and the interventricular septum. Computed tomography initially suggested constrictive pericarditis; however, subsequent echocardiographic assessment and cardiac magnetic resonance imaging supported the diagnosis of restrictive cardiomyopathy secondary to advanced myocardial fibrocalcinosis. No abnormalities of calcium-phosphate metabolism, chronic kidney disease, coronary artery disease, or any other convincing cause of dystrophic or metastatic calcification were identified. Following an extensive differential diagnostic evaluation, a diagnosis of idiopathic massive myocardial calcification was established. This case illustrates the considerable diagnostic challenges in differentiating restrictive cardiomyopathy from constrictive pericarditis and highlights the pivotal role of a multimodality imaging approach in achieving the correct diagnosis.
SN - 2683-1015
SN - 1310-7488
ER -