- I have outlined an overview of MAC and highlighted the relevance to our patient who had CAD.(Abramovitz is an excellent article if you have time)
The relationship of the aortic and mitral valve goes back a long way (for your own interest I wrote a little poem about the relationship)
- re the Aortic Annular Calcification Suffice just to mention that is related to atherosclerosis in other vascular beds. (as is MAC)
- Our Case
- MAC IHD and Prior Infarction
- The fat and calcium in the LV apex indicates prior MI
- Extensive MAC with heart block MR and mild MS
- MAC and Caseous Necrosis
- MAC Dextrocardia and Bacterial Endocarditis
Mitral Annular Calcification
- Degenerative process associated with
- cardiovascular risk factors.
- Degeneration from increased mitral valve stress
- Aortic Stenosis
- Hypertrophic Cardiomyopathy
- Also seen in
- chronic kidney disease, (Ca PO4 disorder)
- following radiation therapy.
- Associated with
- arrhythmias and heart blocks
- MS and MR are rare
Mitral Annulus and Aortic Annulus Calcification
MAC and IHD
Examples of Uncommon Complications
Heart Block, MR and MS
SEVERE MITRAL ANNULAR CALCIFICATION
Axial CT through the mitral annulus shows severe mitral annular calcification extending into the ventricular cavity and the ventricular septum.
MAC and Caseous Necrosis
MAC and CASEOUS NECROSIS
69 year old female with MAC who presents with an echo finding of a mass on the mitral valve thought to represent a myxoma. CT confirmed a low-density mass measuring in the soft tissue range associated with mitral annular calcification.
MAC Dextrocardia and Bacterial Endocarditis
Links and References
Abramovitz Y et al Mitral Annulus Calcification. J Am Coll Cardiol 2015;66:1934-1941. (excellent review)