A Heart Bone Made Headlines, but Diseased Heart Valves Grow Real Bone Far More Often

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Forensic examiners in Virginia reported it in the American Journal of Forensic Medicine and Pathology as an os cordis, a “heart bone” familiar in cattle but almost never described in people.

That discovery was incidental and unrelated to the man’s death. But it points to a far more common and medically important fact: the human heart can grow genuine bone, and it does so most often in diseased valves.

In cattle, camels and otters, the os cordis sits in the heart’s fibrous skeleton and is considered normal anatomy. In the Virginia case, published online in early 2025 and in print that September, the bone lay in the triangle of Koch at the location of the atrioventricular node, the cluster of cells that relays the heartbeat signal from the upper to the lower chambers. The man had died of a stab wound to the chest, and the bone was found only because examiners sectioned the heart’s conduction system, which is not routine at autopsy.

In chimpanzees, the picture is less benign. A 2020 study in Scientific Reports scanned 16 chimpanzee hearts and found a dense structure in four, containing bone or cartilage. Every heart with marked myocardial fibrosis showed such a change, and hearts without fibrosis showed none. The authors suggested the os cordis might be a marker of disease in chimpanzees rather than normal anatomy.

Whether the human finding means anything for heart health is unknown. The man’s heart was enlarged and showed moderate atherosclerosis in two coronary arteries, but no fibrosis at all, and the authors raised the possibility that the bone was related to his heart disease while noting they lacked his full medical history. Argentine cardiac surgeon Jorge Trainini has argued that humans normally have a tendon-like structure he calls the cardiac fulcrum in the same area, while the Virginia examiners say their finding was true bone.

A much larger body of evidence comes from the operating room. In a landmark study published in Circulation in 2001, researchers examined 347 heart valves surgically removed from 324 patients between 1994 and 1998. According to the PubMed record, 288 of those valves, or 83%, showed dystrophic calcification, the chalky mineral buildup typical of worn valves.

The more surprising finding was that 36 of the calcified valves, 13% of them, contained mature lamellar bone, the same organized type found in the skeleton, complete with marrow elements and signs of active remodeling. That works out to roughly 1 in 10 of all valves examined. A separate study of 1,177 surgical valve patients published in Virchows Archiv in 2007 found bone or cartilage in 10.9%, more often in men than in women.

The discovery helped reshape how scientists understand calcific valve disease. Rather than a passive process of minerals settling on aging tissue, it appears to involve active, bone-like biology in which valve cells behave in some ways like bone-forming cells.

Bone can also appear outside the valves, a phenomenon pathologists call osseous metaplasia. Such cases are rare and usually reported one at a time.

A 2024 report in AME Case Reports from Beijing Anzhen Hospital described a 9-year-old boy who collapsed after a physical education class. Imaging suggested a tumor in his right atrium. Surgeons removed a cauliflower-shaped mass about 3.5 by 2.5 centimeters at the opening of the inferior vena cava, which turned out under the microscope to be mature bone and marrow with no identifiable cause. He was well five months later.

These cases differ from the os cordis. They arise in diseased or abnormal tissue and can form large masses, while the os cordis is a small, discrete bone within the heart’s structural framework.

Calcified valves are not a curiosity. A 2013 meta-analysis of seven studies summarized by the American College of Cardiology found that 12.4% of people over 75 have aortic stenosis, a narrowing of the main valve leaving the heart, and 3.4% have severe disease.

As the valve stiffens, the heart must work harder to push blood through. Symptoms can include chest pain, shortness of breath, fatigue, dizziness, and fainting, according to the National Heart, Lung, and Blood Institute. Severe cases are treated by replacing the valve, either through open-heart surgery or a catheter-based procedure. No medication has been shown to stop valve calcification once it starts, which is one reason researchers study the bone-forming biology inside these valves.

The Virginia finding does not change any medical advice. It is a single autopsy case, and no one knows how often similar bones occur or whether they affect heart rhythm.

But the broader lesson stands. Bone in the human heart is not as foreign as it sounds, and the most common version is tied to a disease affecting a large share of older adults. Anyone with breathlessness, chest pain, or fainting during exertion should be evaluated by a clinician, who can detect a valve murmur with a stethoscope and confirm it with an echocardiogram.

It is a bone within the heart’s fibrous skeleton, normal in cattle and some other animals. A 2025 report described one at the atrioventricular node of a 39-year-old man.

Can humans really grow bone in the heart?

Yes. The 2001 study found mature bone in 13% of calcified heart valves removed during surgery, and rare reports describe bone forming elsewhere in the heart.

Is valve calcification the same as having a bone in the heart?

Not exactly. Most calcification is mineral buildup, but some calcified valves contain true, organized bone tissue with marrow.

Who is most affected by calcified valves?

Older adults. About 12.4% of people over 75 have aortic stenosis, according to a 2013 meta-analysis.

Did the bone cause the Virginia man’s death?

No. He died of a stab wound, and examiners described the heart bone as an incidental finding.