Pericardial calcification

Case contributed by Amir Mahmud , 15 Nov 2020
Diagnosis certain
Changed by Arlene Campos, 13 Feb 2024
Disclosures - updated 9 Jun 2023: Nothing to disclose

Updates to Case Attributes

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Pericardial calcification may occur secondary to a wide variety of inflammatory insults ranging from viral infections, uraemia, and pericarditis, which usually result in a more thin, egg shelleggshell pattern of calcification, to more aggressive inflammatory conditions such as TB, in which thick, confluent, and irregular calcification may be seen.

The presence of pericardial calcification itself does not imply constrictive pericarditis and may be an asymptomatic incidental finding. However, other features of constrictive cardiac failure such as pleural effusion(s), retrograde flow of contrast into a dilated IVC, and leftward deviation of the interventricular septum should be evaluated for.

The normal pericardial thickness on the CT scan should be less than 2 mm[1] 1.

  • -<p><a href="/articles/pericardial-calcification" title="Pericardial calcification">Pericardial calcification</a> may occur secondary to a wide variety of inflammatory insults ranging from viral infections, uraemia and pericarditis, which usually result in a more thin, egg shell pattern of calcification, to more aggressive inflammatory conditions such as TB, in which thick, confluent and irregular calcification may be seen.</p><p>The presence of pericardial calcification itself does not imply <a href="/articles/constrictive-pericarditis" title="Constrictive pericarditis">constrictive pericarditis</a> and may be an asymptomatic incidental finding. However, other features of constrictive cardiac failure such as pleural effusion(s), retrograde flow of contrast into a dilated IVC and leftward deviation of the interventricular septum should be evaluated for.</p><p>The normal pericardial thickness on the CT scan should be less than 2 mm<sup>[1]</sup></p>
  • +<p><a href="/articles/pericardial-calcification" title="Pericardial calcification">Pericardial calcification</a> may occur secondary to a wide variety of inflammatory insults ranging from viral infections, uraemia, and pericarditis, which usually result in a more thin, eggshell pattern of calcification, to more aggressive inflammatory conditions such as TB, in which thick, confluent, and irregular calcification may be seen.</p><p>The presence of pericardial calcification itself does not imply <a href="/articles/constrictive-pericarditis" title="Constrictive pericarditis">constrictive pericarditis</a> and may be an asymptomatic incidental finding. However, other features of constrictive cardiac failure such as pleural effusion(s), retrograde flow of contrast into a dilated IVC, and leftward deviation of the interventricular septum should be evaluated.</p><p>The normal pericardial thickness on the CT scan should be less than 2 mm<sup> 1</sup>.</p>
Presentation was changed:
Patient withThe patient has a history of right upper quadrant pain, jaundice, ascites, and difficulty in breathing on and off.

References changed:

  • 1. Bull R, Edwards P, Dixon A. CT Dimensions of the Normal Pericardium. Br J Radiol. 1998;71(849):923-5. <a href="https://doi.org/10.1259/bjr.71.849.10195005">doi:10.1259/bjr.71.849.10195005</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/10195005">Pubmed</a>
  • [1] Bull RK, Edwards PD, Dixon AK. CT dimensions of the normal pericardium. Br J Radiol. 1998 Sep;71(849):923-5.

Updates to Study Attributes

Findings was changed:

There is irregular, thick, and extensive calcification involving the anterior, left, and infero-basal portions of the pericardium.

This is a non-contrast study. There is no pleural effusion seen,; however, the proximal most-most part of the inferior vena cava just before it drains into the right atrium is dilated, which is suggestive of retrograde flow due to pericardial constriction.

Annotation 'anterior' (on Image 1 (CT (oral contrast/ soft tissue (mediastinal) window))) is not linked from the findings

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