Calcific Cardiomyopathy in Advanced Renal Failure

Krishan K. Arora, MD; Jerome P. Lacy, MD; Richard A. Schacht, MD; Denis G. Martin, MD; Charley F. Gutch, MD
Arch Intern Med. 1975;135(4):603-605. doi:10.1001/archinte.1975.00330040115019.
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Congestive heart failure in uremia is most often due to a variable combination of fluid overload, hypertensive cardiovascular disease, coronary artery disease, anemia, and arteriovenous fistula.1 -3 It may, on occasion, be due to calcification of the myocardium.4,5 We describe four uremic patients in whom intractable heart failure and atrioventricular block developed as a result of metastatic myocardial calcification.

PATIENT SUMMARIES  The clinical, biochemical, and pathological findings of the cases are shown in the Table.

Patient 1.  —A 26-year-old man was seen in September 1970, with a blood pressure of 240/170 mm Hg and bilateral papilledema. Urinalysis revealed protein (3+) and eight to ten red blood cells, with many granular casts per high-power field. The blood urea nitrogen (BUN) value was 25 mg/100 ml, and that for serum creatinine was 2.7 mg/100 ml. Blood pressure was lowered with the parenteral administration of hydralazine hydrochloride and diazoxide, and then


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