[Caseous mitral annulus calcification: a case report]

Caseous calcification of the mitral annulus is a rare entity, often unrecognised by clinicians and radiologists alike. It can be difficult to diagnose on echocardiography, with the risk of confusion with cardiac tumours or pseudomasses. In this context, we report the case of a 40-year-old female patient with a notable medical history of arterial hypertension and chronic renal failure, admitted to the hospital with infectious pneumonitis complicated by right-sided chest pain. An echocardiogram performed as part of the work-up revealed severe aortic narrowing, calcification of the mitral annulus, moderate mitral insufficiency and severe tricuspid insufficiency. For pre-operative assessment, a coroscan was performed, demonstrating a hypodense formation in the aortomitral trigone, consistent with caseous calcification of the mitral annulus. This case illustrates the diagnostic complexity of multiple valve anomalies associated with cardiovascular and metabolic risk factors. It also highlights the crucial importance of multimodal imaging in refining the differential diagnosis and optimising the therapeutic strategy. This case thus contributes to the medical literature on the management of annular and caseous calcifications.