April 1975

Calcific Cardiomyopathy in Advanced Renal Failure

Author Affiliations

From the Division of Nephrology and Hypertension, University of Louisville School of Medicine, Louisville (Drs. Arora, Lacy, Schacht, and Martin), and the Renal Section, University of Arizona Medical Center and Veterans Administration Hospital, Tucson (Dr. Gutch).

Arch Intern Med. 1975;135(4):603-605. doi:10.1001/archinte.1975.00330040115019

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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