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Mitral annular calcification. Clinical and echocardiographic correlations
Insights
Mitral annular calcification (MAC) is often linked to rheumatic heart disease, chronic renal failure, or noninflammatory causes. Echocardiography effectively detects MAC and helps distinguish between rheumatic and nonrheumatic origins.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Mitral annular calcification (MAC) is a cardiovascular condition with diverse etiologies.
- Clinical presentations of MAC can overlap with other cardiac diseases, necessitating accurate diagnostic methods.
Purpose of the Study:
- To present clinical, echocardiographic, and radiographic findings in patients with mitral annular calcification.
- To evaluate the sensitivity of echocardiography in detecting MAC and differentiating its causes.
Main Methods:
- Retrospective analysis of 41 patients with diagnosed mitral annular calcification.
- Review of clinical diagnoses, echocardiographic data, and radiographic findings (x-ray, cinefluoroscopy).
Main Results:
- Common clinical diagnoses included rheumatic heart disease (32%), noninflammatory calcific disease (34%), and chronic renal failure (32%).
- Echocardiography identified MAC as a dense echo band beneath the posterior mitral leaflet.
- Radiographic detection of MAC was limited (5% on x-ray, 38% on cinefluoroscopy).
- Echocardiography revealed enlarged left atria and thickened mitral leaflets with reduced motion in rheumatic cases, contrasting with preserved motion in nonrheumatic cases.
Conclusions:
- Echocardiography is a sensitive tool for detecting mitral annular calcification.
- Echocardiographic findings can aid in differentiating between rheumatic and nonrheumatic mitral annular calcification.
- MAC is associated with conditions such as idiopathic hypertrophic subaortic stenosis, chronic renal failure, and bacterial endocarditis.
Abstract:
Clinical, echocardiographic, and radiographic findings in 41 patients with mital annular calcification are presented. Clinical diagnosis included rheumatic heart disease (32%), noninflammatory calcific disease (34%), and chronic renal failure (32%). Mitral annular calcification is recognized echocardiographically as a dense echo band beneath the posterior mitral leaflet with motion paralleling that of the free left ventricular wall. Only two patients of 41 (5%) with mitral annular calcification had calcification on routine x-ray films, and six of 16 (38%) on cinefluoroscopy. The left atrial size is enlarged, and the mitral leaflets are thickened, with reduced motion (D-E) in rheumatic heart disease, but the leaflet motion is well preserved in the nonrheumatic patients. The association of mitral annular calcification with idiopathic hypertrophic subaortic stenosis, chronic renal failure, and bacterial endocarditis is discussed. Echocardiography appears to be a sensitive method of detecting mitral annular calcification and may be helpful in differentiating rheumatic and nonrheumatic etiologies.