Mitral annular calcification (MAC) is a common echocardiographic finding in geriatric population and is usually seen in the posterior atrioventricular groove. In general, MAC does not affect mitral valve functions. Intramyocardial extension is rare. A 67-year-old woman presented with shortness of breath and palpitation. She had a history of hypertension. Physical examination was unremarkable except for arrhythmia and raised blood pressure. The electrocardiogram showed atrial fibrillation with a ventricular rate of 80/min and an incomplete right bundle branch block. A chest radiogram showed a moderately enlarged heart silhouette, transthoracic echocardiography demonstrated a round echogenic mass in the posterior periannular region between the base of the posterior mitral leaflet and contiguous left ventricular wall, suggestive of a cardiac tumor. There were no findings of mitral stenosis or regurgitation in 2D, color and spectral Doppler imaging. Unenhanced cardiac magnetic resonance imaging (MRI) revealed involvement of the posterior mitral annulus and posterobasal myocardial wall, and calcified nature of the mass with no signal intensity. Contrast-enhanced MRI showed no perfusion of the mass. The mass was diagnosed as MAC extending from the posterior mitral annulus to the adjacent myocardial wall.
Keywords: Calcinosis, heart valve diseases/etiology, magnetic resonance imaging, mitral valve/pathologyCopyright © 2025 Archives of the Turkish Society of Cardiology