What is the clinical evidence from this study?

Study design: Case Report. Population: Out-of-hospital cardiac arrest (n=1). Intervention: Cardiopulmonary resuscitation and intensive care. Primary outcome: Histopathological findings at autopsy.

What question did this study set out to answer?

To describe a rare case of rapid intramyocyte microcalcification following out-of-hospital cardiac arrest and prolonged ischemia.

April 22, 2026Open Access

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

Resultado clave

A 42-year-old male who survived 48 hours after an out-of-hospital cardiac arrest exhibited rapid and extensive dystrophic intramyocyte microcalcification in areas of subendocardial infarction.

Puntos clave

To describe a rare case of rapid intramyocyte microcalcification following out-of-hospital cardiac arrest and prolonged ischemia.
Case presentation of a 42-year-old male admitted to ITU after cardiac arrest.
Comprehensive forensic autopsy and specialized cardiac examination conducted.
Histological analysis performed to assess myocardial damage.
Histological examination revealed extensive microcalcification in myocytes of infarcted areas.
No significant traumatic injuries were found during autopsy.
Patient suffered from multiorgan failure and was pronounced dead within 48 hours.

Diseño del estudio

Tipo

Case Report (n=1)

Multicéntrico

PICO estructurado

Población

1 previously healthy 42-year-old male who suffered an out-of-hospital cardiac arrest, had prolonged CPR (60 min), and died within 48 hours of admission.

Rapid dystrophic intramyocyte microcalcification can occur as a rare histological manifestation of severe global myocardial ischemia following cardiac arrest and resuscitation within 48 hours.

Limitaciones

Single case report
No conduction system analysis or molecular autopsy were performed
The cause of the initial cardiac arrest remains undetermined

Resumen

Abstract 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.

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