<prompt> True about metastatic calcificationSerum ca level is normalOccurs in deaddying tissueOccurs in damaged hea valvesCalcification stas in mitochondria  <response>: Metastatic calcification is associated with hypercalcemia and occur in normal tissues and stas in the mitochondria. Metastatic Calcification Metastatic calcification can occur in normal tissues when- ever there is hypercalcemia. The major causes of hypercal- cemia are 1 increased secretion of parathyroid hormone, due to either primary parathyroid tumors or production of parathyroid hormone-related protein by other malignant tumors; 2 destruction of bone due to the effects of acceler- ated turnover e.g., Paget disease, immobilization, or tumors increased bone catabolism associated with multiple myeloma, leukemia, or diffuse skeletal metastases; 3 vitamin D-related disorders including vitamin D intoxication and sarcoidosis in which macrophages activate a vitamin D precursor; and 4 renal failure, in which phosphate reten- tion leads to secondary hyperparathyroidism. Ref: Textbook of Pathology HARSH MOHAN 7th Edition page no.36 