Case Report
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World J Cardiol. Sep 26, 2014; 6(9): 1038-1040
Published online Sep 26, 2014. doi: 10.4330/wjc.v6.i9.1038
Calcific left atrium: A rare consequence of endocarditis
Giuseppe Dattilo, Carmelo Anfuso, Matteo Casale, Vincenza Giugno, Lorenzo Camarda, Natascia Laganà, Gianluca Di Bella
Giuseppe Dattilo, Matteo Casale, Vincenza Giugno, Lorenzo Camarda, Natascia Laganà, Gianluca Di Bella, Department of Clinical and Experimental Medicine, Section of Cardiology, University of Messina, 98125 Messina, Italy
Carmelo Anfuso, Division of Radiology, ‘Ospedali Riuniti Papardo-Piemonte’ Hospital, 98125 Messina, Italy
Author contributions: Dattilo G and Di Bella G undertook the patient clinical examination and echocardiogram; Casale M, Giugno V, Camarda L and Laganà N collected the patient’s clinical data and wrote the paper; Anfuso C performed CT and CMR; Dattilo G and Di Bella G analyzed the data.
Correspondence to: Giuseppe Dattilo, MD, PhD, Department of Clinical and Experimental Medicine, Section of Cardiology, University of Messina, Policlinico G. Martino, Via Consolare Valeria, 98125 Messina, Italy. giu.dattilo@libero.it
Telephone: +39-90-2213531 Fax: +39-90-2213530
Received: February 14, 2014
Revised: April 15, 2014
Accepted: July 18, 2014
Published online: September 26, 2014
Abstract

Usually, cardiac calcifications are observed in aortic and mitral valves, atrio-ventricular plane, mitral annulus, coronary arteries, pericaridium (usually causing constrictive pericarditis) and cardiac masses. Calcifications of atrial walls are unusual findings that can be identified only using imaging with high spatial resolution, such as cardiac magnetic resonance and computed tomography. We report a case of a 43-year-old patient with no history of heart disease that underwent cardiac evaluation for mild dyspnoea. The echocardiogram showed a calcific aortic valve and a hyper-echogenic lesion located in atrio-ventricular plane. The patient was submitted to cardiac magnetic resonance and to computed tomography imaging to better characterize the localization of mass. The clinical features and location of calcified lesion suggest an infective aetiology causing an endocarditis involving the aortic valve, atrio-ventricular plane and left atrium. Although we haven’t data to support a definite and clear diagnosis, the clinical features and location of the calcified lesion suggest an infective aetiology causing an endocarditis involving the aortic valve, atrio-ventricular plane and left atrium. The patient was followed for 12 mo both clinically and by electrocardiogram and echocardiography without worsening of clinical, electrocardiographic and echocardiographic data. Cardiac magnetic resonance imaging and computed tomography are ideal methods for identifying and following over time patients with calcific degeneration in the heart.

Keywords: Endocarditis complications, Left atrium calcification, Cardiac magnetic resonance, Computed tomography

Core tip: A patient was submitted to echocardiography, cardiac magnetic resonance and to computed tomography imaging to better characterize a hyper-echogenic lesion located in the atrio-ventricular plane. The clinical features and location of the calcified lesion suggest an infective aetiology causing an endocarditis involving the aortic valve, atrio-ventricular plane and left atrium.