Coconut atrium secondary to end-stage renal failure treated with long-term haemodialysis

Coconut atrium secondary to end-stage renal failure treated with long-term haemodialysis Cardiovascular flashlight 2433 doi:10.1093/eurheartj/ehy245 CARDIOVASCULAR FLASHLIGHT Online publish-ahead-of-print 24 April 2018 .................................................................................................................................................... Coconut atrium secondary to end-stage renal failure treated with long-term haemodialysis Andrew Panayiotou* and Benjamin Holloway Department of Clinical Radiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, B15 2TH, UK * Corresponding author. Tel: 1447748867439, Email: a.panayiotou.frcr@gmail.com; apanayiotou369@gmail.com Co-author We present a case of a 27-year-old Caucasian male patient with extensive dystrophic predominantly left atrial calcification secondary to haemodialysis. He underwent an unenhanced Computed tomography (CT) thorax for shortness of breath, which revealed dense calcifica- tion of the left atrial wall extending to the intra-atrial septum and also involving the atrial appendage, coronary arteries, aortic root, and to a lesser extent the mitral valve (Panels D and E). He has a past medical history of end-stage renal failure secondary to branchio-oto-renal syn- drome. Following a failed renal transplant, he had been on long-term haemodialysis from 2008 and developed severe hyperparathyroidism in 2013 requiring a parathyroidectomy. Echocardiogram confirmed the calcification and also revealed severe left ventricular hypertrophy (Panels A–C) as well as left atrial and ventricular dysmotility. Coconut atrium (otherwise known as porcelain atrium that involves the interatrial septum) is a rare condition almost exclusively seen in patients with rheumatic heart disease and has been described only once on patients with end-stage renal failure. Serial chest CT images reveal the progressive calcification of the left atrium and adjacent structures (Panels F–H) over 5 years shortly after the onset of haemodialy- sis. Clinicians should be aware of this rare complication of end-stage renal failure in patients on haemodialysis. Published on behalf of the European Society of Cardiology. All rights reserved. V The Author(s) 2018. For permissions, please email: journals.permissions@oup.com. Downloaded from https://academic.oup.com/eurheartj/article-abstract/39/25/2433/4983963 by Ed 'DeepDyve' Gillespie user on 03 July 2018 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Heart Journal Oxford University Press

Coconut atrium secondary to end-stage renal failure treated with long-term haemodialysis

European Heart Journal , Volume Advance Article (25) – Apr 24, 2018
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Publisher
Oxford University Press
Copyright
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissions@oup.com.
ISSN
0195-668X
eISSN
1522-9645
D.O.I.
10.1093/eurheartj/ehy245
Publisher site
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Abstract

Cardiovascular flashlight 2433 doi:10.1093/eurheartj/ehy245 CARDIOVASCULAR FLASHLIGHT Online publish-ahead-of-print 24 April 2018 .................................................................................................................................................... Coconut atrium secondary to end-stage renal failure treated with long-term haemodialysis Andrew Panayiotou* and Benjamin Holloway Department of Clinical Radiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, B15 2TH, UK * Corresponding author. Tel: 1447748867439, Email: a.panayiotou.frcr@gmail.com; apanayiotou369@gmail.com Co-author We present a case of a 27-year-old Caucasian male patient with extensive dystrophic predominantly left atrial calcification secondary to haemodialysis. He underwent an unenhanced Computed tomography (CT) thorax for shortness of breath, which revealed dense calcifica- tion of the left atrial wall extending to the intra-atrial septum and also involving the atrial appendage, coronary arteries, aortic root, and to a lesser extent the mitral valve (Panels D and E). He has a past medical history of end-stage renal failure secondary to branchio-oto-renal syn- drome. Following a failed renal transplant, he had been on long-term haemodialysis from 2008 and developed severe hyperparathyroidism in 2013 requiring a parathyroidectomy. Echocardiogram confirmed the calcification and also revealed severe left ventricular hypertrophy (Panels A–C) as well as left atrial and ventricular dysmotility. Coconut atrium (otherwise known as porcelain atrium that involves the interatrial septum) is a rare condition almost exclusively seen in patients with rheumatic heart disease and has been described only once on patients with end-stage renal failure. Serial chest CT images reveal the progressive calcification of the left atrium and adjacent structures (Panels F–H) over 5 years shortly after the onset of haemodialy- sis. Clinicians should be aware of this rare complication of end-stage renal failure in patients on haemodialysis. Published on behalf of the European Society of Cardiology. All rights reserved. V The Author(s) 2018. For permissions, please email: journals.permissions@oup.com. Downloaded from https://academic.oup.com/eurheartj/article-abstract/39/25/2433/4983963 by Ed 'DeepDyve' Gillespie user on 03 July 2018

Journal

European Heart JournalOxford University Press

Published: Apr 24, 2018

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