Pericardial calcification

Pericardial calcification is usually seen in individual patients with a history of pericarditis and may be associated with constrictive pericarditis

Although historically infective pericarditis was the most common cause, a wide variety of insults can lead to calcification of the pericardium. 

Pericardial calcification is more common over the right side, anterior and diaphragmatic aspects of the heart in the atrioventricular grooves 7. Calcifications over the left ventricle or cardiac apex are rare, unless pericardial calcification is extensive. It is important to assess for signs of associated constrictive pericarditis.

  • a curvilinear density at the extreme margin of the cardiac silhouette (better on lateral view)
  • extension of calcification over the pulmonary outflow tract (better on lateral view)
  • dilated ​left atrium: due less pericardial investment, even with pericardial constriction, mimicking mitral stenosis

Tuberculous calcifications are the most dense, in the atrioventricular grooves and appear as thick, amorphous oblique circles or arcs of calcifications then spread over the atria and ventricles 7.

Medical management is ineffective, and surgical resection of the diseased pericardium is usually performed.

The differential diagnosis for pericardial calcifications include:

Article information

rID: 1858
System: Chest, Vascular
Synonyms or Alternate Spellings:
  • Pericardial calcifications
  • Calcification of the pericardium
  • Calcification of pericardium

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Cases and figures

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  • Case 6: associated with tuberculosis
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