Mitral annular calcification

Case contributed by Dr Jeremy Jones

Presentation

72 year old male presented with breathlessness and cardiac chest pain. Hypertensive with a history of ischaemic and valvular heart disease.

Patient Data

Age: 72 yrs
Gender: Male
Modality: X-ray

There is dense, amorphous calcification within the cardiac silhouette arranged in a curvilinear path that corresponds to the location of the annulus of the mitral valve.

Modality: Photo

Mitral annulus calcification: pathology specimen

This autopsy specimen demonstrates thickened mitral valve leafelts, with marked stenosis. The mitral annulus calcification is seen as pale white 'lumps' under the endothelium around the margins of the valve. 

Case Discussion

On the chest x-ray, there is mitral annular calcification. His cardiac chest pain was treated appropriately and a 12 hour Troponin confirmed that he had suffered some myocardial necrosis.

A subsequent echocardiogram confirmed significant mitral stenosis and angiography confirmed significant 3 vessel disease.

He was transferred to the local cardiac unit for three vessel CABG and mitral valve replacement. His post surgical recovery was uneventful.

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Case Information

rID: 2631
Case created: 7th May 2008
Last edited: 7th Sep 2015
Systems: Vascular, Chest
Inclusion in quiz mode: Included

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