Idiopathic calcification of the ascending aorta and aortic valve in two young women.

Two young women are described with extensive, dystrophic calcification of the ascending aorta and aortic valve.Both patients had mild aortic stenosis and one also had severe aortic insufficiency.In neither case was the aorta dilated.The cause of these unusual changes is unknown.Extensive calcification of the ascending aorta is an unusual finding, and is almost always due to syphilis.Thus, it is frequently associated with dilatation of the ascending aorta, aneurysm formation, and aortic incompetence, and occurs predominantly in middle- aged and older men.In this report we describe the unusual combina- tion of extensive tubular calcification of the non- dilated ascending aorta associated with aortic valve calcification in two young women.The aetiology of these changes is unknown. Case reports Case iAn asymptomatic I7-year-old girl was referred to the Cardiovascular Unit of the Toronto General Hospital in August I962 because a systolic murmur had been heard on routine physical examination.She was born pre- maturely and had had scarlet fever at age 5 without arthritis or cardiac involvement.The only abnormal physical findings were a grade 3/6 systolic ejection murmur best heard at the second right intercostal space, radiating towards the carotids and the apex, and a grade i/6 blowing early diastolic murmur along the left sternal border.The electrocardiogram was normal, and fluoroscopy showed a normal sized left ventricle, with some hyperactivity of the aorta in keeping with combined aortic stenosis and regurgitation.She remained asymptomatic and was next seen again six years later in I968.On physical examination, the blood pressure was I20/60 mmHg and the arterial pulse had a slow upstroke but was increased in amplitude.The left ventricle was palpable at the 5th left intercostal space between the mid-clavicular and anterior axillary line.The first and second heart sounds were normal.There