Abstract
The caseous calcification of the mitral annulus (CCMA) is a rare variant of the mitral annulus calcification (MAC), with prevalence of 0.067% in general population. It is usually an asymptomatic condition but rarely it can cause severe mitral valve dysfunction, embolization, and conduction abnormalities. Transthoracic echocardiography (TTE) is a useful diagnostic tool. However, it can be necessary a multi-modality imaging approach for a differential diagnosis among other intra-cardiac masses. We are presenting a case of CCMA in an 88-year-old woman admitted to our department for acute decompensation of chronic heart failure. TTE has shown pathognomonic findings of CCMA. Tridimensional trans-esophageal echocardiography (3D TEE) gave a better characterization of the CCMA, avoiding further diagnostic procedures.
Highlights
The mitral annular calcification (MAC) is a relatively common degenerative condition of the mitral valve affecting the elderly with an estimated prevalence of 8.5% in general population [1]
We are presenting a case of calcification of the mitral annulus (CCMA) in an 88-year-old woman admitted to our department for acute decompensation of chronic heart failure
Transthoracic echocardiography (TTE), which is the initial imaging test, shows a typical intra-cardiac mass with a central echo-lucent area, calcified edges, without acoustic shadowing [8]. It can be necessary a multi-modality imaging approach, with computed tomography (CT) scan or cardiac magnetic resonance (MR) in order to make a differential diagnosis among other intra-cardiac masses [9]
Summary
The mitral annular calcification (MAC) is a relatively common degenerative condition of the mitral valve affecting the elderly with an estimated prevalence of 8.5% in general population [1]. It can cause severe mitral valve dysfunction and it could be necessary a surgical treatment. TTE, which is the initial imaging test, shows a typical intra-cardiac mass with a central echo-lucent area, calcified edges, without acoustic shadowing [8] Sometimes, it can be necessary a multi-modality imaging approach, with computed tomography (CT) scan or cardiac magnetic resonance (MR) in order to make a differential diagnosis among other intra-cardiac masses [9].
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