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Current Trends in Cardiology | Volume: 03
10
th
WORLD HEART CONGRESS
&
6
th
International Congress on
CARDIOLOGY AND CARDIAC SURGERY
December 02-03, Dubai, UAE
Joint event on
Curr Trend Cardiol, Volume: 03
Notes:
Caseous calcification of the mitral annulus. Report of a case
Juan Francisco Pérez Salúm
EACVI - HIT Ambassador, Paraguay
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.
Biography
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:
perezsalum@hotmail.comFig1: Mass anchored to the posterior
ring of the mitral valve
Fig. 2: Zoom of the mass