Rapidly progressing, massive mitral annular calcification. Occurrence in a patient with chronic renal failure
Depace, N.L.; Rohrer, A.H.; Kotler, M.N.; Brezin, J.H.; Parry, W.R.
Archives of Internal Medicine 141(12): 1663-1665
1981
ISSN/ISBN: 0003-9926 PMID: 7305574 Document Number: 178926
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.