CMAJ • July 29, 2008; 179 (3). doi:10.1503/cmaj.070099.
© 2008 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
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Tracheal calcification

Sang-Ho Jo, MD MMS, Young-Jin Choi, MD PhD, Goo-Yeong Cho, MD PhD, Hyun-Sook Kim, MD PhD, Ki-Suck Jung, MD PhD and Chong-Yun Rhim, MD PhD

Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang-si, Gyeonggi-Do, Korea

A 92-year-old woman was admitted to our hospital because of congestive heart failure aggravated by uncontrolled atrial fibrillation. A chest radiograph showed extensive tracheal calcification (Figure 1). This finding is common in elderly patients and is seen almost exclusively in patients aged 40 years and older. Although visually remarkable, this finding is of no practical clinical significance. However, tracheal calcification may occur more often among patients who have taken an anticoagulation medication, such as warfarin sodium, for several years.1 Although the mechanism by which warfarin causes tracheal calcification is unknown, it may inhibit the normal formation of a vitamin K–dependent protein that prevents calcification of cartilage and connective tissue.2


Figure 123
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  		Figure 1: Chest radiograph showing extensive tracheobronchial calcification forming a clear outline of the patient's large and smaller airways, which are usually radiolucent.

 

Footnotes

Clinical images are chosen because they are particularly intriguing, classic or dramatic. Submissions of clear, appropriately labelled high-resolution images must be accompanied by a figure caption and the patient's written consent for publication. A brief explanation (300 words maximum) of the educational significance of the images with minimal references is required.


REFERENCES

  1. Taybi H, Capitanio M. Tracheobronchial calcification: an observation in three children after mitral valve replacement and warfarin sodium therapy. Radiology 1990;176:728-30.[Abstract/Free Full Text]
  2. Price PA, Faus SA, Williamson MK. Warfarin causes rapid calcification of the elastic lamellae in rat arteries and heart valves. Arterioscler Thromb Vasc Biol 1998;18:1400-7.[Abstract/Free Full Text]




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