The Roentgenologic Appearance of Pericardial Calcification

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ALTHOUGH each year brings additional types of cardiovascular disease within the realm of surgical correction, pericardectomy for chronic constrictive pericarditis remains dramatic in its curative end-results.

Calcification is often a diagnostic aid in this disease. Pericardial calcification per se, however, does not necessarily imply constrictive pericarditis. An adhesive pericardium may be present and yet not interfere with cardiac function or produce symptomatology. Conversely, the absence of demonstrable pericardial calcification does not preclude the existence of a noncalcific constrictive pericarditis. Nevertheless, pericardial calcification is unequivocal evidence of pericardial disease. It is the end result of an inflammatory process, frequently tuberculosis pericarditis.

Calcification may assume various shapes within the pericardium: small plaques; irregular bands; forklike, linear, arcuate, or branching deposits; encompassing rings, or huge egg-shell encasements. Various authors1,2 have indicated the coronary sulcus and the surfaces of the right ventricle to be the commonest sites of calcification. In our experience it has been demonstrated along the left cardiac border with great frequency, and more commonly over the ventricles than over the auricles. A complete dense tiara of calcification outlining the auriculoventricular sulcus has been found several times with no antecedent history of disease and no signs or symptoms.3 We have seen one such case (fig. 1) in a 33 year old white woman having no history or clinical findings of pericardial or cardiac abnormality. In this case the history and residual roentgen evidence of an old empyema indicate the possibility of a contiguous pyogenic pericarditis as a probable etiologic consideration.

Roentgenologically, pericardial. . .



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