# Heart as white as stone, reborn: an unusual case report of idiopathic myocardial calcifications leading to end-stage heart failure and cardiac transplantation

## TL;DR

A rare case of heart failure caused by unknown heart calcifications led to a successful heart transplant with no recurrence after nine years.

## Contribution

This case report demonstrates that heart transplantation can be a viable treatment for idiopathic myocardial calcifications.

## Key findings

- A 61-year-old patient developed heart failure due to massive myocardial calcifications with no identifiable cause.
- The patient successfully underwent heart transplantation at age 66 with no recurrence of calcifications over nine years.
- Heart transplantation may be a safe and reasonable option for end-stage heart failure caused by idiopathic myocardial calcifications.

## Abstract

Massive myocardial calcifications without an underlying cause are a rare entity of unknown pathophysiology that could result in heart failure with preserved ejection fraction and restrictive physiology. The role of heart transplantation in these cases is unclear due to a lack of data and a concern that calcifications could reoccur in a transplanted organ.

We describe herein a 61-year-old patient who presented with new-onset heart failure with preserved ejection fraction. Multimodality imaging evaluation was consistent with restrictive cardiomyopathy secondary to massive myocardial calcifications. Extensive workup did not detect an underlying aetiology that could lead to development of myocardial calcifications. Eventually, at the age of 66, the patient underwent successful heart transplantation without evidence of calcification recurrence during a long-term follow-up of 9 years.

Massive myocardial calcifications could result in end-stage heart failure. Heart transplantation might be considered a safe and reasonable therapeutic option in patients with idiopathic myocardial calcifications.