Mitral annular calcification

Case contributed by Sajoscha A. Sorrentino
Diagnosis certain


Pre-operative screening.

Patient Data

Age: 70 years
Gender: Female

Preoperative chest radiograph


There is a band of coarse calcification projected over the expected location of the mitral valve, to the left of midline. Prominence of the left atrial appendage, but no gross evidence of left atrial enlargement. The pulmonary trunk is clearly demonstrated and not enlarged. Normal cardiac size.

The lungs are clear although there are coarsened bronchovascular markings.

Annotated images

Annotated image

Heavy nodular calcification (yellow) is noted projecting over the cardiac silhouette. 

Approximate locations of the 4 heart valves are noted on the second image:

  • aortic valve (red)
  • pulmonary valve (blue)
  • mitral valve (yellow)
  • tricuspid valve (orange)

Case Discussion

This case demonstrates calcification of the mitral valve annulus (not to be confused with mitral valve leaflet calcification which is the result of, and can cause, mitral valve disease).

Coarse calcification is seen in the expected location of the mitral valve, to the left of midline.  It is associated with conduction defects and coronary artery disease.

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