Current Trends in Cardiology

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Caseous calcification of the mitral annulus. Report of a case

Joint Event on 10th WORLD HEART CONGRESS & 6th International Congress on CARDIOLOGY AND CARDIAC SURGERY
December 02-03, Dubai, UAE

Juan Francisco Perez Salum

EACVI - HIT Ambassador, Paraguay

Posters & Accepted Abstracts : Curr Trend Cardiol


Male, 60 years old, hypertensive, dyslipidemic treated with atorvastatin 20 mg daily. He consumes losartan 50 mg every 12 hours. He was smoker of 10 packages year until 3 years before the examination. He does not have hospitalizations or previous surgeries. He denies symptoms. The patient came to our center to undergo a transthoracic echocardiogram control, in the context of his arterial hypertension.

On the echocardiography we found a severe concentric hypertrophy, mild dilation of the left atrium, mild central mitral valve insufficiency. A rounded echodense image with a regular surface of up to 2.22 cm by 1.75 cm was observed, anchored to the posterior ring of the mitral valve and extending to the posterior leaflet, which due to its characteristics is compatible with caseous calcification of the mitral annulus.

According to Deluca et. Al, the prevalence of caseous calcification of the mitral annulus is very low (0.06-0.07%); up to 0.6% of patients with mitral ring calcification. This type of calcification is described as a chronic degenerative process of greater frequency in elderly patients, with chronic renal disease, women and hypertensive patients. It most often begins in the basal zone of the posterior mitral valve and it may extend to the entire annulus.

The caseous material is composed of a calcified cover and inside it a mixture of calcium, fatty acids and cholesterol. Caseous calcification of the mitral annulus can be confused with abscesses and tumors. It is essential to make a good correlation with the clinic, in order to avoid unnecessary surgeries.


Juan Francisco Pérez Salúm is a doctor in Medicine and Surgery from the National University of Asunción. He is Specialist in Clinical Cardiology and Images in Cardiology. Completed his PhD in Health Administration and Master in Transoesophageal Echocardiography and Management of Hospital Centers. He is an Ambassador in Paraguay of EACVI -HIT (Heart Imagers of Tomorrow - European Association of Cardiovascular Imaging). He also worked as a theatre actor. And a writer in his free times. 

E-mail: [email protected]