RAPID PROGRESSION OF MITRAL AND AORTIC-STENOSIS IN A PATIENT WITH SECONDARY HYPERPARATHYROIDISM

A 68 year old woman with chronic renal failure on long-term haemodialy sis presented with progressive dyspnoea. Serial echocardiography showe d a rapid reduction in mitral valve area from 2.18 to 0.92 cm2 over 18 months. In addition, the previously non-stenotic aortic valve was fou nd to be severely stenotic with a valve area of 1.05 cm2. Cardiac cath eterisation confirmed these findings. The patient had undergone subtot al parathyroidectomy more than 10 years before but had chemical and cl inical evidence consistent with recurrent hyperparathyroidism. The pat ient underwent successful mitral and aortic valve replacement with rel ief of symptoms. Rapid progression of both aortic and mitral valve ste nosis in the presence of secondary hyperparathyroidism is a rare findi ng.