Coronary Artery Calcification Seen Through Chest Radiography

Patients with end-stage renal disease (ESRD) on dialysis have poor overall survival, and cardiovascular (CV) is the main cause of mortality among these patients. Coronary calcification is an independent predictor of mortality and CV events in dialysis patients and can be accessed by using a computer...

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Main Authors:	Neves, Precil D. M. M., Bridi, Ramaiane A., Elias, Rosilene M., Moyses, Rosa M. A.
Format:	Online
Language:	English
Published:	Elmer Press 2015
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4522993/

id	pubmed-4522993
recordtype	oai_dc
spelling	pubmed-45229932015-08-06 Coronary Artery Calcification Seen Through Chest Radiography Neves, Precil D. M. M. Bridi, Ramaiane A. Elias, Rosilene M. Moyses, Rosa M. A. Case Report Patients with end-stage renal disease (ESRD) on dialysis have poor overall survival, and cardiovascular (CV) is the main cause of mortality among these patients. Coronary calcification is an independent predictor of mortality and CV events in dialysis patients and can be accessed by using a computerized tomography scanning. The high cost of this procedure, however, precludes routine implementation of this method for the purposes of risk stratification. Aortic arch calcification has been associated with CV mortality in the general population. Also, vascular calcification beyond the thoracic aorta has been shown to be associated with mortality in ESRD patients. We presented here a case of a young patient with ESRD in which the coronary calcification could be cleared seen through simple chest radiography. This is a 35-year-old man with a history of ESRD secondary to pyelonephritis, who was receiving conventional hemodialysis thrice a week for the last 5 years. He was submitted to chest radiography as part of routine annual cardiac screening. His blood pressure was within the target limits, although much higher in lower limbs, generating a high ankle brachial index of 1.3. He also had secondary hyperparathyroidism. His physical examination was unremarkable, except for the presence of non-functioning arteriovenous fistulas in both arms and a central venous catheter. The last routine blood test showed calcium 9.0 mg/dL, phosphate 5.7 mg/dL, potassium 4.7 mEq/L, creatinine 7.4 mg/dL, alkaline phosphatase 175 U/L, and parathyroid hormone 1,745 pg/mL. Surprisingly, the chest radiography revealed a calcified aortic valve and a calcified coronary artery. This patient had sudden cardiac death few months after this radiography had been taken. We present here a case of coronary calcification that can be seen through simple chest radiography. Such images are not usually seen, although the risk of vascular calcification is high in this population, and is closely related to CV risk. Chest radiographs, nearly universally available provide a method for assessing coronary artery calcification. Such a finding is intriguing and should alert nephrologists and cardiologists for the high risk of CV death in these patients. Elmer Press 2015-09 2015-07-24 /pmc/articles/PMC4522993/ /pubmed/26251690 http://dx.doi.org/10.14740/jocmr2121w Text en Copyright 2015, Neves et al. http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Neves, Precil D. M. M. Bridi, Ramaiane A. Elias, Rosilene M. Moyses, Rosa M. A.
spellingShingle	Neves, Precil D. M. M. Bridi, Ramaiane A. Elias, Rosilene M. Moyses, Rosa M. A. Coronary Artery Calcification Seen Through Chest Radiography
author_facet	Neves, Precil D. M. M. Bridi, Ramaiane A. Elias, Rosilene M. Moyses, Rosa M. A.
author_sort	Neves, Precil D. M. M.
title	Coronary Artery Calcification Seen Through Chest Radiography
title_short	Coronary Artery Calcification Seen Through Chest Radiography
title_full	Coronary Artery Calcification Seen Through Chest Radiography
title_fullStr	Coronary Artery Calcification Seen Through Chest Radiography
title_full_unstemmed	Coronary Artery Calcification Seen Through Chest Radiography
title_sort	coronary artery calcification seen through chest radiography
description	Patients with end-stage renal disease (ESRD) on dialysis have poor overall survival, and cardiovascular (CV) is the main cause of mortality among these patients. Coronary calcification is an independent predictor of mortality and CV events in dialysis patients and can be accessed by using a computerized tomography scanning. The high cost of this procedure, however, precludes routine implementation of this method for the purposes of risk stratification. Aortic arch calcification has been associated with CV mortality in the general population. Also, vascular calcification beyond the thoracic aorta has been shown to be associated with mortality in ESRD patients. We presented here a case of a young patient with ESRD in which the coronary calcification could be cleared seen through simple chest radiography. This is a 35-year-old man with a history of ESRD secondary to pyelonephritis, who was receiving conventional hemodialysis thrice a week for the last 5 years. He was submitted to chest radiography as part of routine annual cardiac screening. His blood pressure was within the target limits, although much higher in lower limbs, generating a high ankle brachial index of 1.3. He also had secondary hyperparathyroidism. His physical examination was unremarkable, except for the presence of non-functioning arteriovenous fistulas in both arms and a central venous catheter. The last routine blood test showed calcium 9.0 mg/dL, phosphate 5.7 mg/dL, potassium 4.7 mEq/L, creatinine 7.4 mg/dL, alkaline phosphatase 175 U/L, and parathyroid hormone 1,745 pg/mL. Surprisingly, the chest radiography revealed a calcified aortic valve and a calcified coronary artery. This patient had sudden cardiac death few months after this radiography had been taken. We present here a case of coronary calcification that can be seen through simple chest radiography. Such images are not usually seen, although the risk of vascular calcification is high in this population, and is closely related to CV risk. Chest radiographs, nearly universally available provide a method for assessing coronary artery calcification. Such a finding is intriguing and should alert nephrologists and cardiologists for the high risk of CV death in these patients.
publisher	Elmer Press
publishDate	2015
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4522993/
_version_	1613255185475305472

Coronary Artery Calcification Seen Through Chest Radiography

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