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Background <p>Early myocardial calcification is an uncommon histopathological finding and is usually associated with chronic myocardial injury. Rapid intramyocyte microcalcification following global ischemia is rarely described.</p> Case presentation <p>A 42-year-old previously healthy male suffered an out-of-hospital cardiac arrest while cycling. Following prolonged cardiopulmonary resuscitation and return of spontaneous circulation, he was admitted to ITU before being confirmed to have Hypoxic Ischemic Encephalopathy not compatible with life. Despite intensive supportive management for multiorgan failure patient was pronounced dead within 48&#xa0;h of admission. There was no family history of heart disease or sudden cardiac death. The comprehensive forensic autopsy examination revealed no significant traumatic injuries that could account for death. Specialized cardiac examination showed subendocardial haemorrhagic infarction over the left ventricle. Histological examination demonstrated extensive focal intramyocyte microcalcification affecting sub endocardium of both ventricles in the areas of infarction with absence of fibrosis or inflammation.</p> Conclusion <p>This case highlights rapid dystrophic intramyocyte microcalcification as a rare histological manifestation of severe global myocardial ischemia following cardiac arrest and resuscitation. Autopsy pathologists should be aware that subendocardial infarction with or without intramyocyte microcalcification and HIE occur secondary to cardiac arrest in those admitted to ITU and it is essential to investigate the cause of the primary cardiac arrest.</p>

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A case of rapid and extensive cardiac myocyte microcalcification in a patient admitted to intensive care following out-of-hospital cardiac arrest

  • 期刊论文

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  • 发表日期：

    2026年4月20日

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  • Gayath Bimal Jayarathna,
  • Joseph Westaby,
  • Mary N. Sheppard

摘要

Background

Early myocardial calcification is an uncommon histopathological finding and is usually associated with chronic myocardial injury. Rapid intramyocyte microcalcification following global ischemia is rarely described.

Case presentation

A 42-year-old previously healthy male suffered an out-of-hospital cardiac arrest while cycling. Following prolonged cardiopulmonary resuscitation and return of spontaneous circulation, he was admitted to ITU before being confirmed to have Hypoxic Ischemic Encephalopathy not compatible with life. Despite intensive supportive management for multiorgan failure patient was pronounced dead within 48 h of admission. There was no family history of heart disease or sudden cardiac death. The comprehensive forensic autopsy examination revealed no significant traumatic injuries that could account for death. Specialized cardiac examination showed subendocardial haemorrhagic infarction over the left ventricle. Histological examination demonstrated extensive focal intramyocyte microcalcification affecting sub endocardium of both ventricles in the areas of infarction with absence of fibrosis or inflammation.

Conclusion

This case highlights rapid dystrophic intramyocyte microcalcification as a rare histological manifestation of severe global myocardial ischemia following cardiac arrest and resuscitation. Autopsy pathologists should be aware that subendocardial infarction with or without intramyocyte microcalcification and HIE occur secondary to cardiac arrest in those admitted to ITU and it is essential to investigate the cause of the primary cardiac arrest.