Annulus fibrosus calcification of the mitral valve.

نویسندگان

  • N BLOOM
  • G CASHON
چکیده

C ALCIUM deposition in diseased heart valves may be demonstrated frequently in necropsy studies, but these deposits are usually overlooked clinicaIIy unless the heart is carefuIly examined roentgenographically. Sosman1 discusses in detail a simple method of demonstrating the presence of calcific deposits within the heart by x-ray. He suggests a small fluoroscopic aperture and a screen of high intensity, using a 5-inch gap and 5 ma., to locate the calcified valves. The patient is rotated into a slight anterior right oblique position, about 15 to 20 degrees ; then the examiner looks through the heart along the line of the auriculoventricular sulcus. This region can be identified by finding the auriculoventricular junction on the left border and searching obliquely across the heart shadow downward and medially, 45 degrees from the horizontal from this point. In this position, both the aortic and mitral valve calcifications are best seen, but they are difficult to differentiate. If intracardiac calcification is found, the patient is rotated to the left anterior oblique position. In this position, the mitral valve is in the posterior third of the heart shadow, while the aortic valve is’ in the mid-third. The valves will show up as dense irregular nodular masses, similar in appearance to calcified mesenteric glands, and they are darker shadows within the dark heart shadow. Rings of fibroelastic tissue at the roots of the cardiac valves, known as the annuli fibrosi, may become calcified and appear as a solid mass, having a. J-shaped or U-shaped appearance. This is usually considered a senile change, associated with other evidence of senility, such as MSnckeberg’s sclerosis, arcus senilis, and calcified intervertebral discs. It is associated very seldom with organic heart disease. This particular case is presented because of the finding within the heart of a Zarge caIcified mass, apparently not associated with any demonstrable evidence of organic cardiac disease.

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عنوان ژورنال:
  • American heart journal

دوره 30  شماره 

صفحات  -

تاریخ انتشار 1945