Multi-Modality Imaging in Caseous Calcification of the Mitral Annulus: Case Series and Clinical Implications
Abstract
Case series Patients: Female, 78-year-old • Female, 79-year-old • Female, 73-year-old Final Diagnosis: Caseous calcification of the mitral annulus Symptoms: Incidental detection Clinical Procedure: Computed tomography • echocardiography • magnetic resonance image • transesophageal echocardiogram Specialty: Cardiology • Radiology Objective: Rare disease Background: Echogenic masses in the mitral annulus are often incidental findings during routine echocardiography examinations. Most represent the wide spectrum of underlying mitral annular calcifications and usually do not require further diagnostic workup. However, a rare variant called “caseous calcification of the mitral annulus” (CCMA) can be challenging to diagnose and often requires an extensive workup with the use of multiple imaging studies in order to accurately confirm the pathology. Case Reports: The aim of this case series was to illustrate the range of challenges associated with CCMA in various clinical scenarios to highlight the importance of multi-modality imaging in the differential diagnosis. Patient 1 was a 78-year-old asymptomatic woman with a round echo-dense structure incidentally found during a routine echocardiographic examination. Patient 2 was a 79-year-old woman with a suspected mitral abscess. Patient 3 was a 73-year-old woman with an incidentaloma (lung mass), with a concomitant lesion of the mitral annulus. All 3 patients required a unique combination of confirmatory imaging studies to ultimately…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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