Journal of Perioperative Echocardiography

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VOLUME 6 , ISSUE 2 ( July-December, 2018 ) > List of Articles


Caseous Calcification in the Mitral Annulus: An Unusual Presentation in a Young Patient

Sunderlal Negi, Imran Bhat, Srinath Damodaran, Rupesh Kumar

Keywords : Caseous calcification, Echocardiography, Mitral annulus calcification, Rheumatic heart disease

Citation Information : Negi S, Bhat I, Damodaran S, Kumar R. Caseous Calcification in the Mitral Annulus: An Unusual Presentation in a Young Patient. J Perioper Echocardiogr 2018; 6 (2):40-43.

DOI: 10.5005/jp-journals-10034-1087

License: CC BY-NC 4.0

Published Online: 01-08-2019

Copyright Statement:  Copyright © 2018; The Author(s).


Calcification of the mitral valve annulus is a chronic degenerative process commonly seen in the older age group. In developing countries like India, it can occur in later stages of rheumatic heart disease. Caseous calcification (CC) of the mitral annulus is a less described atypical variant of mitral valve calcification commonly reported in the basal area of the posterior mitral leaflet in elderly patients with degenerative diseases. The peculiarity of our case is the early age of development, i.e., CC had developed in a 15-year-old male patient with rheumatic heart disease diagnosed by echocardiography and helped in further management.

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  1. Pomerance A. Pathological and clinical study of calcification of the mitral valve ring. J Clin Pathol 1970;23:354-361.
  2. Schott CR, Kotler MN, Parry WR, Segal BL. Mitral annular calcification. Clinical and echocardiographic correlations. Arch Intern Med 1977; 137: 1143-1150.
  3. Harpaz D, Auerbach I, Vered Z, Motro M, Tobar A, Rosenblatt S. Caseous calcification of the mitral annulus: a neglected, unrecognized diagnosis. J Am Soc Echocardiogr. 2001;14:825–831.
  4. Rajamannan NM, Nealis TB, Subramaniam M, et al. Calcified rheumatic valve neoangiogenesis is associated with vascular endothelial growth factor expression and osteoblast-like bone formation. Circulation. 2005 Jun 21;111(24):3296-3301.
  5. Krapf L, Dreyfus J, Cueff C, Lepage L, Brochet E, Vahanian A et al. Anatomical features of rheumatic and non-rheumatic mitral stenosis: potential additional value of three-dimensional echocardiography. Arch Cardiovasc Dis. 2013 Feb;106(2):111-115.
  6. Fertman MH, Wolff L. Calcification of the mitral valve. Am Heart J 1946;31:580-589.
  7. Allison MA, Cheung P, Criqui MH, et al. Mitral and aortic annular calcification are highly associated with systemic calcified atherosclerosis. Circulation 1. 2006;113:861–866.
  8. Abramowitz Y, Jilaihawi H, Chakravarty T, Mack MJ, Makkar RR. Mitral Annulus Calcification. J Am Coll Cardiol. 2015 Oct 27;66(17):1934-1941.
  9. Deluca G, Correale M, Leva R, Del Salvatore B, Gramenzi S, Di Biase M. The incidence and clinical course of caseous calcification of the mitral annulus. J Am Soc Echocardiogr. 2008;21:828–833.
  10. Sterile, caseous mitral annular abscess. J Am Coll Cardiol 1983;2:186-190.
  11. Kautzner J, Vondrácek V, Jirásek A, et al: Tumor-like mitral annular calcification with central liquefaction. Echocardiography 1993;10:459–463.
  12. Borowski A, Korb H, Voth E, et al: Asymptomatic myocardial abscess. Thorac Cardiovasc Surg 1988;36:338–340.
  13. Gilbert HM, Grodman R, Chung MH, et al: Sterile caseous mitral valve “abscess” mimicking infective endocarditis. Clin Infect Dis 1997;24:1015–1016.
  14. García-Ibarrondo N, Lang RM. [Caseous calcification of the mitral annulus, a rare echocardiographic finding]. Rev Esp Cardiol. 2011 Sep;64(9):828-831.
  15. Gramenzi S, Mazzola AA, Tagliaferro B, Protasoni G, Brusoni D, D'Aloya G, et al. Caseous calcification of the mitral annulus: unusual case of spontaneous resolution. Echocardiography. 2005;22:510–3.
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