Subpleural calcifications and thickening can also occur in some cases [8]. In our patient, these characteristic radiological findings were complemented by definitive diagnostic confirmation through bronchoalveolar lavage demonstrating calcospherites and molecular identification of an SLC34A2 mutation, and the presence of severe pulmonary hypertension with detailed echocardiographic correlation, thereby strengthening diagnostic certainty in the setting of coexisting rheumatic heart disease. The gene discussed is SLC34A2; the disease is pulmonary arterial hypertension.