Chahal Mangeet, Temesy-Armos Peter, Stewart William J
Department of Cardiovascular Medicine, University of Toledo Medical Center, Toledo, Ohio, USA.
Echocardiography. 2011 Apr;28(4):E76-8. doi: 10.1111/j.1540-8175.2010.01321.x. Epub 2011 Mar 10.
A 73-year-old woman was found to have a 1.4 × 3.0 cm heterogeneous echodensity with smooth borders and central echolucency associated with a dynamic left ventricular outflow tract gradient and episodic chest pain. Although mitral annular calcification is a common manifestation, this case represents caseous calcification of the mitral annulus, which is a rare variant with an estimated prevalence of 0.068%. It should not be misinterpreted as an intracardiac tumor, abscess or cyst, as was the initial assumption in this case. The implications of the dynamic left ventricular outflow tract obstruction as the etiology of her episodic chest pain and potential dynamic changes in structure with calcium levels are further elucidated in this case.
一名73岁女性被发现有一个1.4×3.0厘米的不均匀回声密度区，边界光滑，中央回声透亮，伴有动态左心室流出道梯度和发作性胸痛。虽然二尖瓣环钙化是一种常见表现，但该病例为二尖瓣环干酪样钙化，是一种罕见变异，估计患病率为0.068%。不应像本病例最初所设想的那样，将其误诊为心内肿瘤、脓肿或囊肿。本病例进一步阐明了动态左心室流出道梗阻作为其发作性胸痛病因的意义以及结构随钙水平的潜在动态变化。
