title: Severe mitral regurgitation and heart failure due to caseous calcification of the mitral annulus.
abstract: Caseous calcification is a rare form of mitral annular calcification. Echocardiography reveals an echodense mass in the inferior mitral annulus with smooth borders and an echolucent inner core. We present a case where caseous calcification of the mitral annulus caused severe mitral regurgitation, atrial fibrillation and heart failure. Transthoracic echocardiography, transesophageal echocardiography, cardiac magnetic resonance and computed tomography were performed and ensured the diagnosis. The mass was surgically removed and a prosthetic valve was implanted. We conclude that caseous calcification of the mitral annulus should be considered not only in the differential diagnosis of cardiac masses but also in the background of mitral regurgitation, atrial fibrillation and heart failure. This case also represents the usefulness of multimodal imaging in identifying cardiac masses.
authors.affiliation: 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary. pzoltan@kut.sote.hu
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Pozsonyi
authors.forename: Attila
authors.initials: A
authors.lastname: Tóth
authors.forename: Hajnalka
authors.initials: H
authors.lastname: Vágó
authors.forename: Zsófia
authors.initials: Z
authors.lastname: Adám
authors.forename: Astrid
authors.initials: A
authors.lastname: Apor
authors.forename: Nasri
authors.initials: N
authors.lastname: Alotti
authors.forename: Pál
authors.initials: P
authors.lastname: Sármán
authors.forename: Béla
authors.initials: B
authors.lastname: Merkely
authors.forename: István
authors.initials: I
authors.lastname: Karádi
mesh_terms: D000368:Aged; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006349:Heart Valve Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D006350:Heart Valve Prosthesis; D006801:Humans; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000209:etiology