Reversible Myocardial Calcification Following Acute Heart Failure and Kidney Injury Caused by Valsalva Sinus Rupture

Abstract

A 47-year-old previously healthy man was referred to a local hospital with chest tightness, oliguria, and lower extremity edema for seven days. An initial investigation revealed acute heart failure and kidney injury. The patient was intensively treated with cardiac and renal replacement therapy, and cardiorenal function improved one week later. Two months later, echocardiography was performed because chest tightness and edema had not resolved. Echocardiography showed Valsalva sinus rupture, and the patient was transferred to our center. Myocardial calcification was observed in the left ventricular wall on computed tomography after admission. The patient underwent cardiac surgery and recovered smoothly. At the three-year follow up, the patient was asymptomatic with normal renal function and serum electrolytes. Imaging revealed a significant reduction in diffuse calcification of the left ventricular wall. This case indicates that this rare form of reversible myocardial calcification may be associated with acute heart and renal failure caused by Valsalva sinus rupture. The results of this case will guide clinicians about further management and timely referral of such patients to appropriate specialties.