Rapid onset of myocardial calcification following septic shock due to influenza superinfection: a case report

TL;DR

A 42-year-old pregnant woman developed rare heart calcification after a severe flu-related infection, with her heart function surprisingly improving despite the condition.

Contribution

This case report highlights a rare and rapid onset of myocardial calcification following septic shock due to influenza superinfection.

Findings

Subepicardial calcification of the left ventricle was observed on CT at Day 8 in a patient with septic shock.

Left ventricular function paradoxically improved despite worsening calcification, as measured by ejection fraction and strain.

Factors like acidosis, vasopressor use, and ARDS may be linked to septic-related myocardial calcification.

Abstract

Myocardial calcification is an unusual complication of septic cardiomyopathy. Dystrophic calcification may occur after damage to myocardial tissue, but its occurrence is rare.

A 42-year-old pregnant woman with no past medical history was admitted in intensive care for respiratory distress caused by bacterial superinfection of influenza. Subepicardial calcification of the left ventricle appeared on a computed tomography at Day 8. Calcification worsened quickly, but we observed a paradoxical improvement in left ventricle function, as assessed by left ventricular ejection fraction and global longitudinal strain using echocardiography with speckle tracking.

The pathophysiology of myocardial calcification is not fully understood, but prolonged haemodynamic failure, profound acidosis, high vasopressor doses, and acute respiratory distress syndrome were previously associated with septic-related myocardial calcification.

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