Pericardial calcification

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

Pathology

Causes

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

On chest radiography, 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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