Heart of Stone: Rare Case of Incidentally Detected Endocardial Calcification

A 76-year-old female with hypertension and hyperlipidemia was evaluated for incidental left ventricular calcification. Despite recent exertional chest pain, she was largely asymptomatic. Cardiac imaging revealed extensive endomyocardial calcifications without significant coronary artery stenosis. Laboratory tests excluded hypercalcemia, hyperparathyroidism, and sarcoidosis, leading to a diagnosis of idiopathic calcific cardiomyopathy. This case highlights the importance of comprehensive cardiac imaging in detecting subtle abnormalities, even in asymptomatic patients from non-tropical regions. It emphasizes considering both metastatic and dystrophic causes of endomyocardial calcification, regardless of geographical location. Given the patient’s asymptomatic status and the condition’s benign nature, a conservative management approach with regular monitoring was adopted. This case contributes to the limited literature on incidental endomyocardial calcification and may inform future strategies for similar presentations.