'Coconut' Atrium: A case report and review of the literature

“Coconut atrium” or complete dystrophic left atrial wall calcification is rare and occurs almost exclusively in the middle-aged and the elderly, often following chronic conditions such as rheumatic heart disease, end-stage renal disease and tuberculosis. Hyperparathyroidism, lipid storage disease and use of xenografts are known causes of incomplete intra-cardiac dystrophic calcification in older children. The present report describes a rare case of cardiac calcification demonstrated by Trans-thoracic 2-D Echocardiography in a two-year old Indian boy who presented at a private hospital in Hyderabad, India with breathlessness. Unfortunately, his parents declined further extensive investigations and treatment, but this case was instructive due to the rarity of complete dystrophic left atrial wall calcification, the exclusion of the common known aetiologies and the extremely young age of the patient.