23114              CALCIFIED PERICARDIUM

The patient was a man aged 55 who had been admitted 3 years previously with congestive cardiac failure, and was readmitted 13 months later atrial tachycardia.  His last admission was preceded by breathlessness, swelling of the ankles and pain in the right side of the chest, episodically for 2 months.  He had lost 19 kilos in weight in 6 months, and recently had bruised easily.  He had always been a heavy smoker and drank moderately.  On examination he was hypertensive, drowsy and in biventricular failure.  There were many cutaneous bruises.  Investigation showed chronic renal failure.  He died from an intracerebral haemorrhage after falling out of bed.  At postmortem the liver was cirrhotic and both kidneys were small and scarred (weight 135 gms and 140 gms).  The heart weighed 600 gms.

The specimen consists of a horizontal slice through the heart to show an almost complete thick ring of calcification surrounding the ventricles and most of the atria.  At the top of the specimen calcification extends into the myocardium of the left ventricle.  There was no history of tuberculosis.