Tran et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Mitral regurgitation can be a debilitating disease that has many etiologies. Frequent causes are mitral valve prolapse, rheumatic fever, dilated cardiomyopathy, and infective endocarditis. Another rare, but often overlooked cause is caseous calcification of the mitral annulus. This rare disease can lead to dangerous complications such as stroke and arrhythmias. In this report, we present an 84-year-old male with chronic kidney disease who was found to have mitral regurgitation secondary to caseous calcification of the mitral annulus. The goal of this report is to bring clinical awareness to this disease so that it is included in the differential diagnosis of mitral regurgitation.