Pericardial calcification

Changed by Ammar Haouimi, 17 Jun 2019

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Pericardial calcification usually occurs in patients with a history of pericarditis.

Pathology

Aetiology

uraemia
previous trauma or prior pericarditis
later sequelae of rheumatic heart disease
malignant pericardial involvement (e.g. mediastinal teratoma)
post-radiotherapy⁵

On chest radiography, the location of the calcifications can help differentiate pericardial calcifications from myocardial calcifications caused by ventricular aneurysms. While pericardial calcification is seen more commonly over the right ventricle, myocardial calcifications are seen more commonly over the left ventricle ³.

Differential diagnosis

The differential diagnosis for pericardial calcifications include:

constrictive pericarditis: in the setting of heart failure with concern for constrictive pericarditis or restrictive cardiomyopathy, calcifications are highly suggestive of the former
chronic adhesive pericarditis in the absence of constriction: less dense with a more patchy distribution ¹
rheumatic pericarditis ²
myocardial calcification (e.g. from left ventricular aneurysm)

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Pericardial calcification

Updates to Article Attributes

Pathology

Aetiology

Differential diagnosis

See also