Singh Birgurman, Murray Christopher J, Eniola Hassan Abdulraheem, Kaur Nirmal J
Internal Medicine, Saint Peter's University Hospital, New Brunswick, USA.
Internal Medicine, Saint Peter's University Hospital, New Brunswick , USA.
Cureus. 2025 May 15;17(5):e84146. doi: 10.7759/cureus.84146. eCollection 2025 May.
Caseous mitral annular calcification (CMAC), a rare variant of mitral annular calcification (MAC), predominantly affects older adults. CMAC represents a very small fraction of MAC, and it features a necrotic core with peripheral calcifications, mimicking neoplasms. Multimodal imaging is essential for diagnosis. We present a case of an 86-year-old hypertensive male patient who presented with exertional dyspnea. Transthoracic echocardiography revealed severe left ventricular hypertrophy, a left cardiac mass, and severe MAC. Cardiac MRI confirmed CMAC (12×14 mm calcified mass). He was managed medically and surveilled with serial echocardiograms. While asymptomatic cases may regress, complications (emboli, valve dysfunction) warrant surgery. Advanced imaging prevents misdiagnosis, guiding intervention. CMAC necessitates multimodal imaging for accurate diagnosis. Conservative management with serial monitoring is appropriate in asymptomatic patients, underscoring the importance of clinician awareness to mitigate complications. Early recognition ensures optimal outcomes in these rarer etiologies.
干酪样二尖瓣环钙化（CMAC）是二尖瓣环钙化（MAC）的一种罕见变体，主要影响老年人。CMAC在MAC中所占比例非常小，其特征是有一个坏死核心并伴有周边钙化，类似肿瘤。多模态成像对于诊断至关重要。我们报告一例86岁男性高血压患者，该患者因劳力性呼吸困难就诊。经胸超声心动图显示严重左心室肥厚、左心肿块和严重MAC。心脏磁共振成像证实为CMAC（12×14毫米钙化肿块）。对其进行了药物治疗，并通过系列超声心动图进行监测。虽然无症状病例可能会消退，但并发症（栓塞、瓣膜功能障碍）需要手术治疗。先进的成像技术可防止误诊，指导干预。CMAC需要多模态成像以进行准确诊断。对于无症状患者，采用系列监测的保守治疗是合适的，这凸显了临床医生提高认识以减轻并发症的重要性。早期识别可确保在这些较为罕见的病因中获得最佳治疗效果。
