title: Myocardial infarction as the first probable manifestation of caseous calcification of the mitral annulus.
abstract: Calcification of the mitral annulus is a common echocardiographic finding during routine evaluation of patients. Caseous calcification of the mitral annulus (CCMA) on the other hand is a rare variant, occurring in about 0.06-0.07% of echocardiographic studies. The authors present the case of a 73-year-old woman admitted to hospital with an anterior wall acute coronary syndrome, in whom transthoracic echocardiography showed a well-defined echogenic rounded mass measuring 27 x 22 mm in diameter attached to the posterior mitral annulus. After transesophageal echocardiography and magnetic nuclear imaging, which confirmed the characteristics of the mass, the patient underwent surgical resection of the mass and mitral replacement with a mechanical prosthetic valve. Histological examination confirmed the diagnosis. Systemic embolism associated with CCMA is a rare but possible complication and was probably the cause of the acute coronary syndrome in this patient.
authors.affiliation: Serviço de Cardiologia, Hospital de Santarém, Santarém, Portugal. davidluisdurao@hotmail.com
authors.forename: David
authors.initials: D
authors.lastname: Durāo
authors.forename: Maria da Luz
authors.initials: Mda L
authors.lastname: Pitta
authors.forename: Miguel
authors.initials: M
authors.lastname: Alves
authors.forename: Nuno
authors.initials: N
authors.lastname: Cabanelas
authors.forename: Maria
authors.initials: M
authors.lastname: Peres
authors.forename: Júlio
authors.initials: J
authors.lastname: Aranha
authors.forename: Isabel
authors.initials: I
authors.lastname: Monteiro
authors.forename: Vítor Paulo
authors.initials: VP
authors.lastname: Martins
authors.forename: Alcides
authors.initials: A
authors.lastname: Francisco
authors.forename: Margarida
authors.initials: M
authors.lastname: Leal
authors.forename: José
authors.initials: J
authors.lastname: Loureiro
authors.forename: Graça Ferreira
authors.initials: GF
authors.lastname: da Silva
mesh_terms: D000368:Aged; D002114:Calcinosis / Q000150:complications* / Q000473:pathology; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications* / Q000473:pathology; D006801:Humans; D008943:Mitral Valve; D009203:Myocardial Infarction / Q000209:etiology*