Mitral Annular Calcification Differential Diagnoses

Updated: Mar 06, 2017
  • Author: Saurabh Sharma, MD; Chief Editor: David J Maron, MD, FACC, FAHA  more...
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DDx

Diagnostic Considerations

Mitral annular calcification (MAC) often takes unusual configurations, which can raise concerns about neoplasm, abscess, or thrombus. In general, any prominent echo-bright abnormality in the posterior annulus region is likely to be MAC. Tumor, infection, and clot are distinctly unusual in this location.

Caseous annular calcification is an unusual form of MAC in which there is a prominent mass in the annulus with a liquid or gelatinous center. At surgery, the contents have been described as having the texture of gruel or toothpaste. Caseous MAC has an estimated prevalence of approximately 0.6% of all cases of MAC. [85]  At times MAC can also be mobile or produce mobile projections, which can embolize and be a source of stroke.

Differential Diagnoses