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Tophaceous mitral value: Report of a case
The American Journal of Surgical Pathology
|January 1, 1982
Summary
A tophus, a deposit of uric acid crystals, was incidentally found in a patient's mitral valve during surgery for gout. This finding highlights the potential for urate crystal deposition in cardiac tissues.
Area of Science:
- Cardiovascular Pathology
- Rheumatology
- Gout Pathophysiology
Background:
- Tophaceous gout is a chronic manifestation of hyperuricemia, characterized by urate crystal deposition in various tissues.
- Mitral valve prolapse is a common cardiac condition requiring surgical intervention.
- Cardiac involvement in gout is rare, with limited documentation of tophi in heart valves.
Observation:
- A surgically resected mitral valve from a patient with known tophaceous gout was examined.
- Histological analysis revealed a tophus with characteristic features of urate deposition.
- Birefringent, dichroic crystals, consistent with monosodium urate, were identified within the tophus.
Findings:
- The presence of a tophus within the mitral valve leaflets was confirmed.
- The histological findings were consistent with deposition of uric acid crystals.
- This represented an incidental intraoperative finding during mitral valve surgery.
Implications:
- This case demonstrates that tophaceous gout can manifest in cardiac structures, specifically the mitral valve.
- It underscores the importance of considering systemic urate deposition in patients with advanced gout.
- Further research may explore the prevalence and clinical significance of cardiac tophi.