Caseous calcification of the mitral annulus: computed tomography features

Assunção, Fernanda Boldrini; Oliveira, Diogo Costa Leandro de; Santos, Alair Augusto Sarmet Moreira Damas dos; Nacif, Marcelo Souto

doi:10.1590/0100-3984.2015.0096

Cited by 5 publications

(4 citation statements)

References 15 publications

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“…Mitral annular calcification (MAC) is a chronic degenerative process associated with advanced age, particularly in women, hypertensive individuals and patients with chronic renal failure. 1 MAC is most commonly diagnosed on echocardiography and can also be seen on chest x-ray, cardiac computed tomography (CT) and cardiac magnetic resonance imaging (MRI). 2 MAC is typically identified in the posterior annulus, which is a C-shaped fibrous structure extending from left fibrous trigone to right fibrous trigone of the mitral valve.…”

Section: Introductionmentioning

confidence: 99%

Ruptured caseous calcification of the mitral annulus

Allwood

Bonacci

McKinnon

2020

Australas J Ultrason Med

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Mitral annular calcification (MAC) is considered a chronic and degenerative process involving the fibrous annulus of the mitral valve. The prevalence of MAC has been reported between 8% and 15%. It significantly increases with age, often seen in females, individuals with hypertension, chronic kidney disease and those with multiple cardiovascular risk factors. Caseous calcification of the mitral annulus (CCMA) (also known as caseoma) is a rare variant of MAC and should be considered in the differential diagnosis with other cardiac masses of the mitral valve. An 85-year-old female presented for a transthoracic echocardiogram with a history of hypertension and a systolic murmur. The echocardiogram demonstrated a possible rare variant of MAC, with independent mobile echodensities identified. Further testing using transoesophageal echocardiography was used to confirm diagnosis and ensure appropriate clinical management was arranged. This case demonstrated CCMA, a benign condition that can be mistaken for cardiac tumours, thrombus, vegetations or abscesses. A low prevalence has been reported between 0.06% and 0.07% and 0.6% of patients with MAC using echocardiography. Echocardiography can provide the initial diagnosis for identification and characterisation of MAC. CCMA appears as a calcified mass with an echolucent, liquid-like inner part, located on the posterior mitral valve annulus. Acoustic shadowing is usually absent. Multimodality imaging can lead to an accurate diagnosis of CCMA without unnecessary interventions. Transoesophageal echocardiography provides further information on the site and composition of the internal material. Computed tomography (CT) and cardiac magnetic resonance imaging (MRI) can also be used, to confirm the diagnosis and to exclude other differential diagnoses.

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Section: Introductionmentioning

confidence: 99%

Ruptured caseous calcification of the mitral annulus

Allwood

Bonacci

McKinnon

2020

Australas J Ultrason Med

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“…CCMA usually occurs in the elderly and especially in women. It is also associated with hypertension, chronic renal failure and altered calcium phosphate metabolism 3–7 . It is a massive annular calcification with a toothpaste‐like structure containing calcium, fatty acids and cholesterol 2,4 .…”

Section: Discussionmentioning

confidence: 99%

“…It is also associated with hypertension, chronic renal failure and altered calcium phosphate metabolism. [3][4][5][6][7] It is a massive annular calcification with a toothpastelike structure containing calcium, fatty acids and cholesterol. 2,4 The mechanism of formation is not yet known.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of caseous calcification of the mitral annulus causing mitral stenosis and mimicking the clinical picture of infective endocarditis: A case report

et al. 2023

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Among masses involving the mitral valve and annulus, caseous calcification of the mitral annulus (CCMA) is a rare disease. CCMA accounts for .63% of all mitral annular calcification (MAC) cases. The pathophysiology is still unknown. The correct diagnosis and treatment of this disease is very important to prevent complications. We present a case of giant CCMA with advanced mitral stenosis and hypertrophic cardiomyopathy, presenting with symptoms of infection and therefore a preliminary diagnosis of infective endocarditis. Because of these features, we wanted to share our case as it is the 1st case in the literature.

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“…Studies on the cardiovascular system have recently been prominent in the radiology literature of Brazil 3 - 6 . One study published in this issue of Radiologia Brasileira represents an innovative step forward in the understanding of the CAC score within the literature of Brazil.…”

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confidence: 99%

Deriving the coronary artery calcium score from computed tomography of the chest

Trad¹

2018

Radiol Bras

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Caseous calcification of the mitral annulus: computed tomography features

Cited by 5 publications

References 15 publications

Ruptured caseous calcification of the mitral annulus

Ruptured caseous calcification of the mitral annulus

Surgical treatment of caseous calcification of the mitral annulus causing mitral stenosis and mimicking the clinical picture of infective endocarditis: A case report

Deriving the coronary artery calcium score from computed tomography of the chest

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