Necrotic Mitral Annular Calcification a potential source of embolism: Case report

Written By : Dr Sravan Kumar |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-10-14T09:00:05+05:30 | Updated On 14 Oct 2021 9:00 AM IST

Mitral annular calcification (MAC) characterized by periannular calcium deposits is a degenerative abnormality commonly seen in elderly population. Caseous calcification of the mitral annulus (cMAC) is a rare form of mitral annular calcification with central liquefaction necrosis.

Simon M Frey, reported a case wherein patient, a 71 year old female patient had Mitral annular calcification. Tissue characterization with cardiac magnetic resonance (CMR) revealed a cMAC and a conservative approach was chosen. At followup patient developed acute hemi occlusion of a retinal artery with cholesterol embolism.

At this time, CMR showed a liquefied cavity of the cMAC. Except for atherosclerotic plaques in the aorta and carotid arteries, further stroke work-up was negative so patient was managed conservatively. During follow-up, the liquefied cavity regressed completely after another 6 months and the patient was free from further events during 3 year followup.

Important learning points from above study are-

1) Caseous Mitral annular calcification is a dynamic condition and underestimated as a source of potentially serious complications, such as mitral regurgitation and systemic embolization

2) CMR with multi-parametric tissue characterization can help to diagnose and quantitatively assess the process of liquefaction of MAC.

Source: European Heart Journal - Case Reports

doi-org.eres.qnl.qa/10.1093/ehjcr/ytab380

mitral annular calcificationscardiac MRIcaseous calcificationseuropean heart journal

Source : European heart journal

Dr Sravan Kumar

MBBS, M. D. Respiratory Medicine

Dr Sravan Kumar V, completed his M. B. B. S from SRMC, Nandyal and M. D. in Respiratory Medicine from the JSS Medical College, Mysore. After completing MD. he worked as Senior resident in Kasturba Hospital, Manipal. He is actively involved in various research activities of the department. Currently he is working as senior resident in Mallareddy medical college for women, Hyderabad. He can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751