Intended for healthcare professionals

Endgames Spot Diagnosis

Dyspnoea and an unusual chest radiograph

BMJ 2017; 356 doi: (Published 09 March 2017) Cite this as: BMJ 2017;356:j986
  1. James SB Kho, radiology specialty registrar1,
  2. David C Howlett, radiology consultant2
  1. 1Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
  2. 2East Sussex Healthcare NHS Trust, Eastbourne, UK
  1. Correspondence to: jamesksb{at}

A 70 year old man presents with shortness of breath over several months. What does his chest radiograph show (fig 1), and what are the most common causes of this condition?

Fig 1

Chest radiograph

Short answer

The chest radiograph shows pericardial calcification. Given his symptoms, consider echocardiography, as pericardial calcification is associated with constrictive pericarditis. Although it is often idiopathic, recognised causes of constrictive pericarditis include infection, …

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