Multimodality imaging of caseous mitral annular calcification complicated by possible systemic embolizations

Area of Science:

• Cardiology
• Radiology
• Pathology

Background:

• Caseous mitral annular calcification (CMAC) is a rare degenerative condition affecting the mitral valve annulus.
• CMAC can present with varied clinical manifestations, including chest pain and embolic events.
• Accurate diagnosis and understanding of complications are crucial for patient management.

Purpose of the Study:

• To report a clinical case of CMAC presenting with chest pain.
• To illustrate the diagnostic pathway using echocardiography and cardiac computed tomography (CT).
• To highlight the complication of multiple embolizations in a patient with CMAC.

Main Methods:

• Initial patient assessment included echocardiography for cardiac structure and function evaluation.
• Cardiac computed tomography (CT) was performed for detailed anatomical assessment of the mitral annulus.
• Diagnostic findings were correlated with clinical presentation and potential embolic sequelae.

Main Results:

• Echocardiography provided initial insights into mitral valve annular abnormalities.
• Cardiac CT precisely delineated the extent and characteristics of caseous calcification.
• The diagnosis of CMAC was confirmed, complicated by evidence of multiple embolizations.

Conclusions:

• Echocardiography and cardiac CT are valuable tools in diagnosing CMAC and its complications.
• CMAC should be considered in the differential diagnosis of chest pain, especially with embolic phenomena.
• Prompt recognition of CMAC-related emboli is essential for appropriate therapeutic strategies.