ArticleCureus2025
Pulmonary Alveolar Microlithiasis Coexisting With Rheumatic Heart Disease and Severe Pulmonary Hypertension: A Case Report.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
Pulmonary Alveolar Microlithiasis (PAM) is a rare diffuse lung disease characterized by intra-alveolar calcium phosphate microlith accumulation. Its coexistence with rheumatic valvular heart disease with resultant severe pulmonary hypertension is exceedingly uncommon and poses unique diagnostic and management challenges. This case underscores the importance of maintaining a broad differential diagnosis, emphasizing that new or worsening respiratory symptoms in patients with established cardiac disease should not be automatically attributed to cardiac pathology alone. We report the case of a 63-year-old gentleman with longstanding rheumatic heart disease (RHD) who presented with progressive dyspnoea. Clinical evaluation revealed features suggestive of severe pulmonary hypertension. Investigations confirmed PAM with characteristic "sandstorm" calcifications on chest imaging, supported by bronchoalveolar lavage demonstrating calcospherites and identification of an
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