MRCP2-4200

MRCP2-4200

A 79-year-old man was admitted to the hospital from a residential home due to chest pain. He had a history of ischaemic heart disease and had suffered a myocardial infarction eight years ago. His congestive cardiac failure was well controlled with medication. The only other notable event in his past was a chest injury sustained during his time in the armed services sixty years ago when he was hit by shrapnel while serving in North Africa. He was born and raised in India but had lived in the United Kingdom for his entire adult life, working as a secondary school teacher and later as a headmaster of a boys’ boarding school. His ECG showed lateral ST segment elevation and his serum troponin T was elevated. The chest x-ray revealed pleural calcification at the right base. What is the most likely cause of pleural calcification in this patient?