A proposed role for sepsis in the pathogenesis of myocardial calcification

Bower, Guy; Ashrafian, Hutan; Cappelletti, Simone; Lee, Liang Mei; Harling, Leanne; Ciallella, Costantino; Aromatario, Mariarosaria; Athanasiou, Thanos

doi:10.1080/00015385.2017.1305163

Cited by 10 publications

(4 citation statements)

References 38 publications

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“…Few reports of myocardial calcification caused by myocarditis exist, and the mechanism is yet to be described ( 5 ). Myocardial calcification owing to sepsis is considered to be related to endogenous or exogenous catecholamines ( 4 - 6 ). In the current case, there was no elevated blood calcium level ( Fig.…”

Section: Discussionmentioning

confidence: 99%

An Autopsy Case of Fulminant Myocarditis with Massive Left Ventricular Calcification

Yagi-Nakajima,

Miura,

Sawada

et al. 2024

Intern. Med.

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Myocardial calcification in myocarditis is rare and may be linked to poor outcomes. We herein report a case of fulminant myocarditis with massive myocardial calcification and its pathological outcomes at autopsy. A 49-year-old man experienced chest pain and was diagnosed with acute myocarditis. His cardiac function did not recover despite mechanical circulatory support in combination with V-A extracorporeal membrane oxygenation and IMPELLA CP Ⓡ . He eventually developed sepsis and gastrointestinal bleeding and died on day 27. Diffuse myocardial calcification was observed on computed tomography at autopsy. The pathological autopsy depicted that calcification filled every myocardial cell in the left ventricle.

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Section: Discussionmentioning

confidence: 99%

An Autopsy Case of Fulminant Myocarditis with Massive Left Ventricular Calcification

Yagi-Nakajima,

Miura,

Sawada

et al. 2024

Intern. Med.

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“…Sepsis-related myocardial injury is a very complex process [ 10 , 11 ]. In state of sepsis, dystrophic calcification may take place as a consequence of myocardial injury caused by several cardiotoxic factors, such as oxidative stress, inflammatory cytokines, microvascular ischemia, and excess catecholamine (external or internal).…”

Section: Discussionmentioning

confidence: 99%

Diffuse Myocardial Calcifications Caused by Leptospirosis

Lesjak,

Pirnat

2023

Cureus

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Severe leptospirosis is defined by multiple organ failure. Cardiac involvement is an uncommon complication in patients with leptospirosis, and the pathophysiology of it is not well understood. Diffuse myocardial calcifications connected with sepsis are infrequent, and their effect on heart function is hard to predict. They can lead to conduction disorders and arrhythmias, thereby causing sudden death. Myocardial calcifications are usually revealed incidentally by radiological investigations such as computed tomography (CT) scan in patients with or after sepsis and are commonly unidentified in practice because most cases progress gradually. This case report involves a 51-year-old male who presented to the emergency department with sepsis. The patient was diagnosed with leptospirosis, causing septic cardiomyopathy and diffuse calcifications of the myocardium of the left ventricle. This case highlights the importance of multimodality imaging and a multidisciplinary approach to diagnoses since early recognition and treatment are essential. Follow-up of such patients is necessary to monitor the systolic function of the left ventricle and cardiac arrhythmia.

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“…Unlike other cases of myocardial calcifications that were mostly only affiliated with sepsis, the myocardial calcification in the patient was affiliated with many other pathologies besides including multiple organ dysfunction syndrome (heart, kidney, lung, and liver), systemic inflammatory response syndrome, disseminated intravascular coagulation, septic cardiomyopathy, and metabolic acidosis. A pathogenesis of sepsis-related myocardial calcification has been hypothesized that a complex inflammatory network response might be the primary mechanism causing the myocardial calcification [4]. In animal models that were under sepsis, calcium overload of cardiomyocytes were detected which suggested in myocardial depression [5].…”

Section: Discussionmentioning

confidence: 99%

A case of bi-ventricular extensive calcification caused by multiple factors

Yang

et al. 2020

BMC Pediatr

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Background: Extensive myocardial calcification has a low incidence rate, but when the patients do have extensive myocardial cases, the prognosis is usually poor. Several sepsis-related extensive myocardial calcification cases have been reported, but there are cases of biventricular calcifications that are caused by multiple cases besides bacteremia and the treatment for it has a low percentage of success. Case presentation: A 9 year old girl had an extensive biventricular calcification which is caused by multiple factors including multiple organ failure (heart, lung, liver, and kidney), aseptic cardiomyopathy, systemic inflammatory response syndrome, pulmonary hemorrhage, viral encephalitis. In this case study, the massive myocardial calcification present in the patient was classified as dystrophic. After the patient was transferred to the Intensive care unit, a series of rescue treatments such as anti-inflammatory factor storm were implemented to protect the organs. In the end, the patient was rescued from the rescue treatment procedure. After 18 months of follow-up, it was observed that the patient's heart function returned to normal and it was observed that there was no change in myocardial calcification in the patient. Conclusion: In this case study, it showcased a case of the diffused biventricular calcification that caused by multiple factors. Furthermore, the precise role of calcification on cardiac function was largely unknown and there has to be further follow-up observation on the patient.

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A proposed role for sepsis in the pathogenesis of myocardial calcification

Cited by 10 publications

References 38 publications

An Autopsy Case of Fulminant Myocarditis with Massive Left Ventricular Calcification

An Autopsy Case of Fulminant Myocarditis with Massive Left Ventricular Calcification

Diffuse Myocardial Calcifications Caused by Leptospirosis

A case of bi-ventricular extensive calcification caused by multiple factors

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