On the chest x-ray, there is mitral annular calcification. His cardiac chest pain was treated appropriately and a 12 hour Troponin confirmed that he had suffered some myocardial necrosis.

A subsequent echocardiogram confirmed significant mitral stenosis and angiography confirmed significant 3 vessel disease.

He was transferred to the local cardiac unit for three vessel CABG and mitral valve replacement. His post surgical recovery was uneventful.