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November 1981

Rapidly Progressing, Massive Mitral Annular Calcification: Occurrence in a Patient With Chronic Renal Failure

Author Affiliations

From the Departments of Cardiology (Drs Kotler and Depace and Mr Parry) and Nephrology (Drs Brezin and Rohrer), The Hahnemann Medical College and Hospital, Philadelphia.

Arch Intern Med. 1981;141(12):1663-1665. doi:10.1001/archinte.1981.00340130101023

• Calcification of the mitral annulus developed in a patient while undergoing dialysis. The rapid onset of events corresponded to the onset of end-stage renal failure and uncontrolled secondary hyperparathyroidism. Sequential echocardiograms verified the progression of calcification of the annulus as well as the valve. A new systolic and diastolic murmur and reduced valve orifice on two-dimensional echocardiography suggested acquired nonrheumatic mitral stenosis and insufficiency. We propose that metastatic calcium deposition rather than long-term hypertensive and degenerative effects was the predominant mechanism for massive calcification of the annulus and valve. It is suggested that M-mode echocardiography be used sequentially to follow both the occurrence and progression of calcification of the mitral annulus or valve in patients with chronic renal failure, secondary hyperparathyroidism, or both.

(Arch Intern Med 1981;141:1663-1665)