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Mitral subannular left ventricular aneurysms are not frequently seen, and those described have occurred mostly in Africa and India. This condition is rare in the Caucasian population. In this case report we describe a mitral subannular left ventricular aneurysm which was calcified, in a pregnant, HIV-positive African woman. This condition should be suspected in patients of African or Indian descent presenting with mitral incompetence and a localised bulge and ring calcification on the left cardiac border on a chest radiograph.