Mitral annular calcification

Mitral annular calcification (MAC) is a chronic, degenerative calcification of the mitral valve annulus. It is associated with aging and is more common in women. MAC is often seen in patients with atherosclerosis, and it may be associated with coronary artery disease, hypertension, and diabetes mellitus.

Epidemiology

MAC is a common finding in the elderly population, with a prevalence of 8-15% in those aged 50-60 years and up to 30-40% in those aged 80 years or older. It is more common in women than in men, and the prevalence is higher in individuals with chronic kidney disease or diabetes mellitus.

Pathophysiology

The exact pathophysiology of MAC is not fully understood. It is thought to be related to chronic inflammation and oxidative stress, which lead to the deposition of calcium in the mitral valve annulus. This process is similar to the pathogenesis of atherosclerosis.

Clinical Presentation

Patients with MAC are often asymptomatic. However, in severe cases, MAC can lead to mitral stenosis or mitral regurgitation, which can cause symptoms such as shortness of breath, fatigue, and palpitations.

Diagnosis

MAC is usually diagnosed by echocardiography, which can show the characteristic calcification of the mitral valve annulus. Other imaging modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI), can also be used.

Treatment

The treatment of MAC is primarily aimed at managing the underlying conditions, such as hypertension and diabetes mellitus. In severe cases, surgical intervention may be required.

Prognosis

The prognosis of MAC is generally good, as it is often a benign condition. However, it can be associated with an increased risk of stroke and cardiovascular disease.

See Also

• Mitral valve
• Mitral stenosis
• Mitral regurgitation
• Atherosclerosis
• Coronary artery disease

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