Mitral Stenosis Associated With Valvular Tophi

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Mitral Stenosis Associated With Valvular Tophi JA NAHN SCALAPINO, M.D. Mayo Clinic Proceedings Volume 59, Issue 7, Pages 509-512 (July 1984) DOI: 10.1016/S0025-6196(12)60443-1 Copyright © 1984 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 1 Stillframes of two-dimensional echocardiogram. A, Long-axis view shows the following: (1) thickened, distorted mitral valve, indicated by arrows between left atrium (LA) and left ventricle (LV), which contained large uric acid infiltrate; (2) calcified aortic valve; and (3) thrombus in mid LA, which contained uric acid. B, Short-axis view shows thickened, distorted mitral leaflets. Orifice approximates 1 cm2. A = anterior; AV = aortic valve; I = inferior; L = left; MV = mitral valve; P = posterior; R = right; RV = right ventricle; S = superior; VS = ventricular septum. Mayo Clinic Proceedings 1984 59, 509-512DOI: (10.1016/S0025-6196(12)60443-1) Copyright © 1984 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 2 Surgically excised mitral valve. A and B, Ventricular surfaces of anterior (A) and posterior (B) mitral leaflets show not only chordal thickening and focal fusion but also nodular uric acid deposits (arrows). C, Atrial surface of anterior (Ant) and posterior (Post) mitral leaflets shows rheumatic leaflet thickening and commissural fusion (*). D, Photomicrograph of uric acid crystals in mitral valve. (De Galantha stain, under polarized light; × 175.) Mayo Clinic Proceedings 1984 59, 509-512DOI: (10.1016/S0025-6196(12)60443-1) Copyright © 1984 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 3 A, Surgically excised left atrial mural thrombus. B, Roentgenogram showing focal calcification. Chemical analysis of noncalcified areas demonstrated extensive uric acid composition. Mayo Clinic Proceedings 1984 59, 509-512DOI: (10.1016/S0025-6196(12)60443-1) Copyright © 1984 Mayo Foundation for Medical Education and Research Terms and Conditions