The Curious Clinicians 113 - From Vessel to Bone
Aug 6, 2025
Explore the intriguing phenomenon of calcium deposits in blood vessels and their implications for aging and health. Discover the playful banter between pulmonologists and cardiologists as they analyze the link between coronary artery calcification and dyspnea. Learn about historical insights that shaped our current understanding, including the role of chronic inflammation in vascular calcification. Delve into how these calcifications can serve as indicators of underlying issues while also posing risks for acute coronary events.
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Clinician's Frequent Encounter With Vascular Calcification
- Tony Brew says he sees vascular calcification frequently because his patient population skews very old.
- He realized the ubiquity of this finding warranted deeper study beyond his usual CT reading priorities.
Vessels Can Ossify Into Actual Bone
- C.H. Bunting's 1904 autopsy described "two masses of true bone" with marrow inside an aortic plaque.
- Tony Brew emphasizes vascular calcification can progress to full ossification, not just calcium deposits.
Smooth Muscle Cells Become Osteoblast-Like
- Chronic inflammation and oxidative stress drive vascular smooth muscle cells to adopt osteoblast-like programs via transdifferentiation.
- Apoptotic bodies from dying cells seed microcalcifications that can nucleate larger, bone-like deposits over time.