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 1: Chest radiograph showing extensive tracheobronchial calcification forming a clear outline of the patient's large and smaller airways, which are usually radiolucent.
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 Chong-Yun Rhim MD PhD Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang-si, Gyeonggi-Do, Korea
Footnotes
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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. [DOI] [PubMed]
- 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. [DOI] [PubMed]