Correspondence Address: Dr. Mangalachulli Pottammal Ranjith Bhavatharini, P. O. Pantheerankave, Kozhikode - 673 019, Kerala India
Source of Support: None, Conflict of Interest: None
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DOI: 10.4103/2321-449X.146625
How to cite this article: Ranjith MP, Vinayakumar D, Babu K, Krishnan MN. Rheumatic Mitral Valve Calcification. Heart India 2014;2:117
How to cite this URL: Ranjith MP, Vinayakumar D, Babu K, Krishnan MN. Rheumatic Mitral Valve Calcification. Heart India [serial online] 2014 [cited 2021 Dec 4];2:117. Available from: https://www.heartindia.net/text.asp?2014/2/4/117/146625
A 59-year-old female presented to our emergency department with acute pulmonary edema. On examination, she had irregular pulse and an apical mid diastolic murmur. She was stabilized with standard medications. Echocardiogram revealed calcific mitral stenosis with severe subvalvular pathology. Fluoroscopy showed mitral valve (arrow) and subvalvular apparatus (broad arrow) calcification [Figure 1], Videos 1-3]. She underwent mitral valve replacement. Severe mitral valve apparatus calcification is frequently seen in patients with advanced age and chronic kidney disease, but it is rare in rheumatic heart disease. Mitral valve calcification in rheumatic heart disease usually involves commissures and leaflet tissue, with extension to the annulus in late stage. Balloon mitral valvotomy is contraindicated in such patients and surgical treatment is technically difficult. There is need for adequate debridement and annular reconstruction prior to mitral valve repair or replacement.
Figure 1: Fluoroscopy images showing mitral valve (arrow) and subvalvular apparatus (broad arrow) calcification, (a) right anterior oblique view (b) posteroanterior view, (c) left anterior oblique view
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