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Myocardial infarction induced by caseous mitral annular calcification: a case report
Joseph Cosma1, Julien Wain-Hobson1, Cecilia Gobbi1
1Cardiovascular Institute of Caen, Saint Martin Private Hospital, 18 Rue des Roquemonts, 14000 Caen, France.
Caseous mitral annular calcification (CMAC) is a rare condition causing heart valve dysfunction. This report details a unique case where CMAC led to extrinsic coronary artery compression and myocardial infarction.
Area of Science:
- Cardiology
- Pathology
Background:
- Caseous mitral annular calcification (CMAC) is a rare variant of mitral annular calcification, typically affecting the posterior annulus.
- It can lead to mitral valvular dysfunction, arterial embolization, and outflow tract obstruction, often in elderly patients with comorbidities.
Observation:
- A 68-year-old patient presented with acute myocardial infarction and heart failure.
- Echocardiography and CT revealed a large calcified mass on the posterior mitral annulus causing severe mitral stenosis and extrinsic compression of the circumflex artery.
Findings:
- The patient underwent double valve replacement.
- Histopathology confirmed chronic mitral valve fibrocalcification with aseptic necrosis, consistent with CMAC.
Implications:
- This is the first reported case of extrinsic coronary artery compression caused by CMAC.
- CMAC should be considered in the differential diagnosis of coronary artery compression, especially in patients with valvular abnormalities.
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