Mitral annular calcification

Case contributed by Jeremy Jones
Diagnosis certain


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

Patient Data

Age: 70 yrs
Gender: Male

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.


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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