title: Mitral annulus calcification and sudden death.
abstract: Mitral valve annulus calcification is a degenerative cardiac condition often found at autopsy in the elderly. While usually considered incidental to the cause of death, we report two cases where mitral valve annulus calcification with valve stenosis was associated with sudden death. Case 1: a 61-year-old female who had underlying atherosclerosis and hypertension collapsed at home. At autopsy there was marked mitral valve annulus calcification with valve stenosis and cardiomegaly. Case 2: a previously well 74-year-old female collapsed in a toilet. At autopsy there was marked calcification of the mitral valve annulus with valve stenosis. In both cases death was attributed to the effects of the calcified mitral valve annulus. Although such calcification may be unrelated to the terminal lethal mechanism, the association with left atrial enlargement, atrial fibrillation, mitral regurgitation, mitral stenosis, bacterial endocarditis, ischaemic and thromboembolic stroke, myocardial infarction, and arrhythmias, means that it should not be overlooked in the differential diagnosis in cases of sudden and unexpected death.
authors.affiliation: Forensic Science SA, 21 Divett Place, Adelaide, SA 5000, Australia.
authors.forename: Esther
authors.initials: E
authors.lastname: Quick
authors.forename: Roger W
authors.initials: RW
authors.lastname: Byard
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000473:pathology; D006332:Cardiomegaly / Q000473:pathology; D003324:Coronary Artery Disease / Q000473:pathology; D023921:Coronary Stenosis / Q000473:pathology; D003645:Death, Sudden / Q000209:etiology*; D005260:Female; D049429:Forensic Pathology; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology*; D008946:Mitral Valve Stenosis / Q000473:pathology*; D061205:Vascular Calcification / Q000473:pathology*