What is the Mitral Annulus?
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The mitral annulus is a ring like structure that separates the top and bottom chambers of the left side of the heart. The left side of the heart is the main pumping side. The upper chamber is the left atrium that collects blood returning from the lungs. The lower chamber of the left side of the heart is called the left ventricle, and is the main pumping chamber that pumps blood to the body. The mitral annulus sits in between the top and bottom chamber and houses the mitral valve. It can be thought of as a support ring for the mitral valve. The mitral valve is the valve that stops blood flowing backward from the left ventricle to the left atrium, and therefore allows blood to go forward in to the body where it is needed.
What is Mitral Annular Calcification?
Mitral annular calcification is a chronic process in which there is deposition of calcium in the mitral valve annulus. The mitral annulus is typically flexible. In mitral annular calcification it becomes less flexible and thicker. The posterior annulus is most commonly affected. In the majority of people the amount of calcification is mild and therefore usually of no significance. Calcification of the mitral annulus is increased in situations where there is increased stress on the annulus and valve.
Diagnosis
Mitral Annular Calcification may be associated with a murmur that is picked up on physical examination although often there will be no murmur. The diagnosis of mitral annular calcification is most commonly by echocardiography. As in the pictures above, there is increased calcium deposition seen in the mitral annulus. Mitral annular calcification when severe can be seen on chest x-ray. It can also be picked up on CT scan and MRI scan.
Commonality
Mitral annular calcification is more common in women. 9% of woman and 3% of men over the age of 60 are found to have it on echocardiography. It is also more common in those with mitral valve prolapse. Mitral annular calcification is very common in those with chronic kidney disease, and is found in 40% of those undergoing echocardiography.
Risk Factors
Factors that increase stress on the mitral valve and its surrounding structures increase the chance of mitral valve calcification. The following conditions are associated with development of mitral annular calcification.
- Female sex
- Older Age
- Hypertension
- Mitral Valve Prolapse
- Aortic Stenosis
- Hypertrophic Cardiomyopathy
- Chronic Kidney Disease
- Atherosclerosis
Complications
Several studies have looked at the association of mitral annular calcification and the development of cardiac and other events. There is increased risk of heart attacks, stroke and death from cardiovascular causes. There is also an increased risk of development of atrial fibrillation with RVR, an irregular heart rhythm. The risk is probably explained by the fact that patients with mitral annular calcification have risk factors for cardiovascular disease. The presence of the calcium itself is unlikely dangerous.
The presence of mitral annular calcium makes it harder for surgeons to repair the mitral valve, as surgery is technically more challenging. The calcium in the annulus can make the flexible valve more rigid and predispose to a leaky valve, however that is usually not significant. Mitral annular calcification is rarely associated with obstruction to blood flow and therefore typically will not have symptoms.
Caseous Calcification of the Mitral Annulus
Caseous calcification of the mitral annulus is a rare type of mitral annular calcification where there is extensive calcification and infiltration of the annulus accompanied by a liquid center, a process known as liquefactive necrosis. As can be seen in the picture, this has a remarkable appearance. It is usually benign, however it is important it is recognized, as it can be mistaken for tumor or other more dangerous complications that can lead to unnecessary interventions such as operations. Sometimes it resolves spontaneously.
Treatment of Mitral Annular Calcification
Mitral annular calcification is usually of no clinical significance and no specific treatment such as MitraClip is required. Those with mitral annular calcification are at increased risk of cardiac events, although this is still relatively small, likely due to the presence of traditional cardiac risk factors. Therefore it is reasonable to advise those with mitral annular calcification to pay attention to blood pressure, cholesterol, lifestyle, smoking, diabetes and other common risk factors. This will serve to reduce overall cardiac risk.
Very helpful.
Thank You
I just had an echo and saw for the first time some calcification on my mitral valve. It looks minimal but I have multiple risk elements including recent onset of atrial fib. I will wait until my Cardiologist reads my echo and discusses it with me but until then your article has lessened my concern. Thank you for a well written explanation.
You’ve provided all the info I was seeking, and done it in a way that is easily understood. Thank you.
I read the report of a cat scan and mentioned I had this. I am Diabetic under control. my last A1C was 6. I guess my one concern is As I sit quietly I can feel a click. It is not constant only as I am still and not really often. Have been on warfarin for several years due to a pulmonary embolus no reason found. I see my PCP every 4-6 mths. I know I will be discussing this with him son. For now I am waiting to see if there is Ca in my lungs. Recently diagnosed nodules found.
for now any noncommittal advice would be appreciated.
I wouldn’t worry about the mitral annular calcification for now. At some point an echocardiogram would be advised.
Thank you for responding. The cancer was ruled out. Thank God! Do you recommend anything further for now?
Mitra annular calcification
I had an echocardiogram
My 2D echo says I have Mild Annular Calcification and Mild Mitral Regurgitation. Is there something that I need to worry about? Please help.
My brother in law passed away 5 months ago at the age of 31 from mitral valve prolapse with severe calcification of the annular ring. It was a shock to everyone because he always had a good BP and HR and never have chest pains. The only medical problem he had was severe stomach pains on and off for the past few years. The doctors could never figure it out and passed it off as pancreatitis. The last time he went to the ED, 2 years ago, a doctor said he had dangerously low vitamin D (although the drank milk all the time and was outside most of the day), but everything else seemed to be within normal limits. He did smoke cigarettes for about 12 years but had recently stopped. I was wondering if you had any insight on this? We were told his condition was hereditary and that’s why it was so advanced at such a young age.
I forgot to mention it was sudden cardiac death.
What was the stated cause of death, the valve disease in this setting is very unlikely to have contributed.
The stated cause of death said “mitral valve prolapse with severe calcification of the annular ring”, which caused him to go into sudden cardiac arrest. All of his other organs looked good according to the doctor who did his autopsy and she said she couldn’t even tell he was a smoker because his lungs looked good.
My echocardiography says mild posterior mitral annular calcification with unrestricted valve opening
What is this?
It means there is some calcium in the valve as can be seen with age-ing or other processed, but it is not affecting valve function.
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Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
I have Mitral Annular calcification with mild mitral regurgation..Should I be worried what can I do to overcome this?
Hello sir I have rheumatic heart decease from last 20 yes I am 37 year old right now without operation I have AR grade II MR grade I & This week when I did 2D echo first time for tricuspid valve showing trivial TR . I have concered about it. Pulmonary valve is normal For last 20 years I have done 16 2D echoes but except this for every checking there was nil regurgitation for tricuspid. Positive thing is the all dimensions are same as before LVEF is 62% I don’t have any problems for doing daily activities. Dr only concerned about my heart beat & found sound .very high gradients due to tachycardia. No pulmonary hypertension. He prescribed me 1 tablet Ivabrid 5 half half daily. I am fine but I am concerned. I took nuril 2.5 2 tab daily & penicillin 12 lakhs monthly for last 20 years please give me suggestion
The valvular heart disease appears to be relatively mild in this case and if you have no symptoms then no specific therapy would be advised.
I missed one thing that mitral valve is thincked & heavily calcific & difficult to doctor to assess the severity of the stenosis due to merging of theAR & MS jets & due heavy calcification. Please reply sir. Is it time of surgery
My mitral valve 75% calcified I wish to know is there any effective nonsurgical treatment for above problem .
I’ve had 2 stents, D.C.’s with A-fib, and now a CT this week shows calcification of the mitral annulus. I’m diabetic also with many health issues. My PCP has increased my beta blocker to help with the afib. How concerned should I be?
With regard to the mitral annular calcification i would suggest obtaining an echocardiogram to evaluate the structure and function of the mitral valve. If it is an isolated finding that does not affect the function of the valve you don’t have much cause for concern.
Hi. Is dense MAC with mild to moderate mitral regurgitation something to be worried about?
The valve is of course not normal but the MAC and moderate MR in isolation can often be well tolerated and not a large cause for concern. Surveillance would typically be recommended. If symptoms were to develop then further testing may be required. I would have to see the images to comment accurately.
I missed one thing that mitral valve is thincked & heavily calcific & difficult to doctor to assess the severity of the stenosis due to merging of theAR & MS jets & due heavy calcification. Please reply sir. Is it time of surgery
If i were seeing a similar case, i would do a TEE as the next step with 3D to characterize the valve more accurately.
I appreciate this article very much. I had a mitral valve repair (open heart) that couldn’t be completely done in August 2015 due to “giant bar of calcium posteriorly that precluded placing the valve sutures including the ring sutures.” I had MVP for decades, and severe regurgitation caused me to see the surgeon. After doing the partial repair, the post-op echo showed minor regurgitation. I had none of the palpitations that had plagued me for years for 14 glorious months but they started again. Heart rate goes to 160-170 for 90 minutes and finally settles down to 85 or so. Echo 17 months post-op shows SEVERE REGURGITATION again. Back to square one. Pre- and post-op diagnoses from operative report: “Mitral Annular Calcification, Severe Mitral Annular Calcification, Posterior Leaflet Prolapse; Paroxysmal Atrial Fibrillation.” Seeing surgeon in May for stress echo and consultation. He said maybe not surgery. I’m thin, eat super healthy, good BP, never smoked, no diabetes, 1 drink a month, a few cups of coffee a month. Why do I have these calcifications? Anything I should do? Are the palpitations related to the regurgitation? I get an “attack” about once a month.
Given the severe calcification it is likely that the next operation you have would be a mitral valve replacement and not a repair, particularly if a repair fails. Mitral valve repair is an art form and a lot depends on the ability of the surgeon. If you have truly severe regurgitation and are symptomatic or show other signs of strain, surgery may be advised. The palpitations are likely related to the leaky valve. https://myheart.net/articles/mitral-valve-repair-surgery-what-you-need-to-know/ https://myheart.net/articles/mitral-valve-replacement-surgery/ https://myheart.net/articles/mitral-regurgitation/
Have you checked your Vitamin D3 levels? With your diet & lack of type2Diabetes, I would research what mineral imbalances cause calcium build up (think hard water in your sink drain)
respected doctor, my 47 years old mother’s echocardiography result came and it said mitral valve is calcified, but other three valves are normal. she is obese too. should i consider valve replacement surgery? a suggestion will be appreciated.
Respected doctor, my 47 years old mother is diagnosed with rheumatic heart disease with severe mitral stenosis and mild mitral recurgitation. The mitral valve is calcified. Also there is mild recurgitation in tricuspid valve. What would be the advised steps to treat this? She is obese and does have hyperthyroid. Also she has been asthamatic for about 16 years. A suggestion would be appreciated. Thank you.
She has severe mitral stenosis and will likely require treatment. If the disease is symptomatic the question is, whether she is a candidate for balloon mitral valvuloplasty, or if the calcification means that she will require surgery instead.
Respected doctor, How will i know if she needs valvuloplasty or valve replacement surgery? thanks for replying.
I’m a 34 year old female today I went to the e.r for sever back pain. I was convinced it was my kidneys, after ordering a CT Scan the Dr said my kidneys were fine but the seen 7mm calcification on left atrium. My bP was 140/102 I still have no answers on the sever back pain but now extremely worried about my heart. In suppose to follow up with my primary Dr. Next for an Echo. What could of caused this. Im to young to have heart problems
I would start by clarifying things and seeing what the echo shows before you worry. If the TTE isnt enough an echo known as a TEE may be required.
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Tests I have had, and Angiogram, say my Mitral Valve is calcified, and my heart would Explode
would valve replacement be tried. Am wondering if the new TAVI valve replacement could be
considered for my cause? I am on Oxygen 24/7 as I have no air capacity to do much, without stress! My B/P is fairly normal, I have a highstress # like 83, am 74 years old. Using feurosimide , but no heart medications as of yet! What do you think?
There are many options available even for heavily calcified valves, however i would need to know a lot more about your situation and see the images to comment.
Ridiculonodular opacity middle lobe & mitral valve calcification. Could they be related?
My dad has severe aorta stenosis and mitral valve annular sever calcification. Does this mean he may have to have 2 valves replaced is tavr generally the best option?
It depends on many factors and can be a complex decision. A full heart team approach is advised and a decision balancing risk complete treatment vs. fixing the most sensible first. If it’s only mitral annular calcification without stenosis, the mitral valve won’t necessarily need treatment.
You can follow our twitter at @MustafaAhmedMD
Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
very good information. Thank you.
is mitral and aortic annular calcification progressive? Are there risks involved during surgery with the presence of calcifications?
Which surgery are you referring to?
In general it is felt to be a chronic, somewhat progressive process.
Thank you for the article, it explains the calcification very well. I’m told I have significant mitral regurgitation and I was hoping to have the valve repaired, but have now been told that due to calcification it will probably have to be replaced. I’ve no real symptoms of valve trouble, a little short of breath occasionally but nothing else, but they tell me it’s best to have the operation now while I’m still relatively young and my general health is good.
In many instances calcification does not preclude valve repair, make sure you are seeing an expert reference mitral surgeon.
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Thank you for the article, helped me to understand my condition.
I am 73 suffering from high blood pressure and mild type 2 diabetes. I was recently diagnoised to have very high calcification. I have sofar never been diagonised to have any cardiac disorder. I am now advised to go through Cardio Cath and Echo. I need to know, is there a high probability of me having a cardiac arrest at any time.
Assalamualikum wrwb
My mom 51 years old got 2D echocardiogram and detected
Mitral valve: MAC +
Doctors told normal ..but asked to see the doctor if symptoms persists.
How can we leave it and wait for symptoms.
We are very worried.plz suggest what to do now
If the dr is not worried and there is no tightening or leak of the valve then there is likely no concern.
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Dr. Ahmed
My wife just turned 77. She has a severly calcified mitral valve that her Dr. says needs
replacement. He will not do the surgery because she is too high a risk due to past
problems having major difficulty coming outof antithesia. Surely this issue has came
up in the past. Can’t a lower level be used?
What would you reccomend?
Please excuse the spelling.
In our center, if the patient is high risk for surgery we use different methods such as transcatheter methods that can successfully treat even calcified valves.
https://myheart.net/articles/tmvr-transcatheter-mitral-valve-replacement/
I have been diagnosed with Bicuspid Aortic Valve and mild to moderate Aortic Insufficiency and mild Aortic Stenosis. Age 54.
I have been monitoring progression with echocardiograms every si months. It has been stable.
But in the last echo, there was a finding of moderate Mitral Valve regurgitation and Mitral Annular calcification. Previously, the Mitral Valve was normal.
I don’t know if Mitral Calcification it is related to kidney. My kidney had been normal last year but latest blood report kidney function r has dropped below normal. EGFR=49. Normal=60. Creatinine=1.76. Normal=1.33.
Symptoms: My cardiologist said my November 2017 Treadmill was okay. I had reached the target Heart Rate. I am normal weight but have been feeling tired on exertion but Dr says that is likely caused by aging and fitness rather than valve issues.
Will exxercising and improving my cardiovasculaar fitness improve the symptoms of Aortic and Mitral regurgitation?
Images:
https://drive.google.com/drive/folders/14YnG28n-i1b6qkHQcHDsv0of21iBcGRl?usp=sharing
When you say you get tired do you get overwhelming tired where if you had the opportunity you would fall asleep ? whereas usually you felt just minor fatigue?
Chances are if your lower body (upper thighs and lower legs) feel heavy your heart is working overtime and you should be considered for mitral valve replacement/repair.
You know your body best. Don’t just go with what the doctor feels. Get a second opinion.
My opinion…good luck with that.
Thank you very much.
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I had tricuspid valve repair and mild mitral leak for years. Now I have mild mitral valve annular calcification. My tricuspid repair is now at a moderate leak. My repair was done 14 years ago. My first question is, do they really have to wait for my leak to be severe to replace my valve? my other concern is my body seems to like to grow extra stuff like calcium deposits and scar tissue. I am currently going through a situation with my shoulder having a 3.2cm calcium deposit and a small one right beside that. My second question is should I be concerned about this calcification in my heart
I forgot to ask if you could please Email me your answer. I also have heart palpitations that started like 2 years ago. [email protected]
Dr. I have had numerous chronic health issues, worsening since age 17yrs. I now an a just turned 50 yr old woman who 13months ago had a major open heart,(using the heart lung bypass due to inability to do the Davinci robotic, full sternectomy) to repair mitral valve, Goretex neo-cords x 2 sets to P2,#33 (Medtronic) Duran AnCore annuloplasty Band implanted, left atrial appendage exclusion with #40 Atricure clip. I did have complications that kept me in hospital for close to 3wks.I came from N.C to the Cleveland hospital, where I knew they had a great reputation for what needed to be done. But now with my EDS,& other disorders causing more issues, for I do have dysautanomia (umbrella term for the many other issues, most rare, so far at least 14 documented diagnoses,) my issue is now: my Heart rate is higher than ever, staying even at rest between 110-150. BP averages 130/100- 180/110 when in past it would from my POTS go back and forth between very high to very low. Worsening Pulmonary Hypertension and pulmonary fibrosis, I could go on, but my new concern is , why do I now have calcification on the repaired MV.? this discovered after a contrast CT for abdomen, which was done as emergency 2 wks ago,from chronic GI issues, that have begun again. Do I need to worry about the Valves & go back for a follow up to Cleveland or is this par for the course and I need to just live to my best ability til ???. For I do know that time isn’t my best friend. But if there is something that can prolong and help I want to,just dont want to keep chasing for hope that only is a short time til the inevitable. And yes, I was a healthy, thin build woman, because of my health,I have always took extra care, eating healthy, exercising ( til now cannot) so I am doing my part. But with pain, and deterioration, I am at my wits end, any advise on how normal it is / or do I need to do anything to help myself in regards to the valves ,before I go across country again, would be most helpful and appropriated. Thank you.
Sincerely, TF
Its unlikely the annular calcification is new, rather it was likely there prior to the operations. The symptoms are likely unrelated to the annular calcium.
Thank you, the preoperative Echocardiogram said no seen calcification on any valves, could the fact I have EDS’ or layman’s term. Connective tissue disorder, I did years before have a LINQ put in then after only 3months removed, it had migrated to bottom of breast& no longer worked. I’ve since questioning you, have had more issues arise.. had bloodwork come back at it’s worse, & had upper Endoscopy/lower colonoscopy,& unexpectedly had entire esophagus stretched twice with Savary Dilator to get to 16mm. They also saw need for 4 biopsies of middle &lower 3rd of esophagus, spoke of possible eosinophilic esophagus? But history in family of cancer of esophagus,lung ect.. I now am on disability & told my Cardi.& Surgeon Ohio state Dr.(I’m in NC) is not covered, but have had no Drs.in NC even agree to see me for this issue, saying ,”I’m to high risk& I need to see my Drs.who took care of me originally,& did the surgery. I had BCBSNC then, not Medicaid, I do not know what or how to get help, meanwhile..I hurt, cannot breath comfortably, am homebound more each day, Hypertension worse, tachycardia & Afib. Any suggestions are acceptable, it’s hard even more for they do not deny health deteriorating, just to help me attempt to have a better quality of life, better than nothing, discouraged & disgusted at the fact that who pays,Medicaid or private insurance takes precedence over life. I’m only 50, I have beautiful grandbabies I want to live to see, longer preferred, but though a awesome group “Angels of Mercy”will fly me free (as they did in past to Ohio,every time,God bless them) I cant afford self pay Dr visit, newly separated,I live on the lowest poverty level I never thought even possible.Ready to just wait and if death is my only option, I’ve tried, even attempted medical trials,to no avail. Whether I had calcification before or after, I’m quickly worsening daily, so without care for heart. Again, any suggestions are welcomed.Thank you for taking time to read.Sincerely
T.Filer”
I am 71 yo female, symptom free. I have dyslipidemia: total chol.210-240, LDL 130-160. HDL around 60. Likely genetic, I’m not overweight and have no DM. On recent card.echo mild calcification was found on posterior mitral leaflet, wo significant regurge.Would you recommend cholesterol lowering drug, like Crestor, since high cholesterol maybe associated w valve calcification?
Although theoretically that would make sense to some degree, its not known whether cholesterol meds prevent rate of annular calcification.
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Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
Dear Dr Ahmed,
My father is 82 yrs old, had a TAVR procedure done 7-18 and at that time was aware that he had a leaky Mitral valve. The TAVR procedure was done in Missoula MT and was very successful. We have been watching his health and he is now experiencing a lot of shortness of breath, very low energy, no strength in legs and we just had an Echocardiogram done that showed his Mitral valve has been deteriorating and the Echo results revealed a rather large calcification leading to the surgeons having a concern that if a clip is put on the valve it may cause the valve to be way to tight and cause more problem with the leakage. Our surgeon also mentioned challenges with a complete Mitral valve replacement cause of the challenges with stitching the new valve to an overly calcified area, as well as my fathers current health conditions. My question……is there anything else that can be done? We are waiting to hear tomorrow if the surgeons team believe they can do the clip procedure without causing overdue tightness of the valve. Thank you for taking to reply….Mike
There are a few options (not available in most centers). These include valve in MAC, TMVR replacement, or a hybrid approach. These should only be entertained in the most experienced hands but in the correct patients may be of great use.
You can follow our twitter at @MustafaAhmedMD
Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
This is regarding my father Mr Surinder Kumar who is 76 years old and has been diagnosed with severe MS/MR. He was advised mitral valve replacement surgery but after admission, it was discovered that he suffers from extensive MAC and therefore the surgery would be high risk. Now we have been advised to go for transcatheter mitral valve replacement, which as per our understanding is a new technique.
We want to seek your opinion in this case and would be grateful if you can spare some time and advise us as per the reports below.
Here’s the link to Echo, TEE images https://drive.google.com/open?id=1EmiT3fgn2ALwNiWfDauCtVAMT4W5UO8z
Angiography images: https://drive.google.com/open?id=16OmRhvYRzIvTOEi9nk2oynvjLlI1m_ug
CT Chest plain https://drive.google.com/open?id=1YavFmfx6HkdwxCzFfjOqQcE5H9nfmgWk
CT Chest Contrast https://drive.google.com/open?id=1jyCeI_5iCkveem5oNiwk3U3g9fTO2IQg
The images show severe MS and moderate MR, severe mixed mitral valve disease. If severely symptomatic and felt to have a good prognosis then TMVR in MAC can be considered. We have done these and they can have good results, sometimes a hybrid surgical/catheter approach is preferred. This is a high risk procedure and should only be done in a place experience with this and with good results.
You can follow our twitter at @MustafaAhmedMD
Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
I am a 59 year old women and found out that I have Mitral annular and aortic root calcifications. Also, evidence of calcific atherosclerosis in the following arteries; LAD: 152, Left Circumflex: 24.3, RCA: 35.3 The first echo showed moderate aortic stenosis.
I have been experiencing chest tightness and off and on heart palpitations. Fatigue. I am very sensitive to salt and caffeine, as well as many medications. The salt will make my BP spike if I get to much salt. I watch what I eat to help keep my BP normal. Most of the time it runs 117 to 130/ 65-81. Then if to much salt it will spike to 178-180/ 90-95 and stay there for about 15.The dr wnts me to take statins but I have very bad reactions to all that I have tried. The statin causes dizziness, nausea, joint pain or more fatigue. I am also taking 1 aspirin a day.
What my question is; I am worried since I can not take the statin which is supposed to help decrease the risk. What are my risks and with my symptoms of having the stroke or heart attack sooner rather than later. Would surgery be something I should be considering now. I do not want to wait till there is too much calcification and it can not be fixed.
Mi mama tenia 78 años de edad le diagnosticaron stenosis several de valvula mitral calcificada tenia presion arterial alta y hipertiroides y quisiera saber que debe hacer hoy
his is regarding my father who is 76 years old and has been diagnosed with severe MS/MR. He was advised mitral valve replacement surgery but after admission, it was discovered that he suffers from extensive MAC and therefore the surgery would be high risk. Now we have been advised to consider transcatheter mitral valve replacement, which as per our understanding is a new technique.
We want to seek your opinion in this case, We are willing to officially consult you so you can look at the scans and reports and advise if surgery is an option and if so, which type should we go for- open heart, minimally invasive or transluminal. Many thanks.
Where is he based?
Do you have details of the echo report?
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Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
I am 31 years old, female
my 2 d echo result is
Grade 1 diastolic dysfunction
Mitral annular calcification with mild MR
What should i do doc…
Thank you
What will be the first heart sound intensity in mitral annular or valvular calcification in elderly female patients without any mitral stenosis
i got an echocardiogram and it says the following: tricuspid valve: there is tricuspid annular calcification. trace tricuspid regurgitation. can you help me understand this? Thank you
Hi Dr Ahmed. I’m a 61 yr old female with Lupus, APS, heart disease (score 801) and I have a mechanical mitral valve with a severely calcified annulus. I take warfarin, prednisone and plaquinal daily. I have normal cholesterol, trygliceryides, BP, oxygen saturation (99-100) heart rate @ 60-62 BPM. Is my situation fixable and is there an operation to fix the annulus being that it is heavily calcified?
Thank you!
In general, the calcified annulus wouldn’t need fixing if the mechanical valve is working well.
You can follow our twitter at @MustafaAhmedMD
Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
I had a kidney transplant in April 2019. I have a heart murmur, mitovalve prolapse, hyperthyroidism, atrial fibrillation, and a calcified mitovalve. Is there anyway that I can have an oblation done?
How bad is borderline pulmonary hypertension. I have no shortness of breath.
I put in the wrong email in comment above
I was just diagnosed with Borderline Pulmonary hypertension. I did not have any symptoms such as shortness of breath. How bad is it?
I am 62 Yo and just had my 2D echo 2 days ago.
2D Echo Conclusion:
1. Grade 1 diastolic Dysfunction
2. Mitral Annular Calcification with mild mitral regurgitation
Questions: Any immediate precautions and treatment for these two findings?
Thank you.
It depends on the presence of associated regurgitation and stenosis. The presence of cardiac risk factors should be identified and treated. The annular calcification alone without significant other associated issues is typically watched over time and not specifically treated. Did you discuss these things with the ordering Dr?
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Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
28 yrs old. Diagnosed with tricuspid valve regurgitation, mildly calcified aortic valve, and mildly calcified mitral valve. Experiencing fatigue, shortness of breath, and pressure in chest. What are the best treatment options or is this not that much of a concern right now?
My mother was recently diagnosed with severe mitral valve calcification and was basically told there is not much they can do because of her age 79. Doctor said he would not operate on her because she would not make it through surgery. He said the only option would be a valvoplastia where they place something like a balloon in the valve to keep it open but that it might rupture the valve. He did not seemed very positive and basically was telling me that it was her time. Gave her less than a year. What can I do.?
There are options and trials that your Dr may not be aware of. We do many of those trials in suitable candidates. Did you seek an opinion from an experienced heart team?
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Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
Hi Doctor,
My mother is 56 yr old and she had BMV on 2002 at the age of 37. She was fine after BMV with some medication. On 2014, echocardiogram shows she has mild MS, moderate MR and atrial fibrillation with fast ventricular rate. After that we had regular check up with doctor but recently the echocardiogram report shows 1. RHD with severe calcified mitral stenosis with mild MR with mild aortic stenosis with moderate AR. 2. Severe PAH 3. Markedly dilated LA with suspected LA. Dilated RA &RV also. And patient is in atrial fibrillation. Although echocardiogram has many findings but her pulse is normal (70-80) and BP-74/125. Is Mitral vulve replacement the only option as a treatment and if so then when is the best time for operation. Thank you.
Can “severe” annular calcification of the mitral valve be reversed? My TTE shows no mitral stenosis or prolapse, but the calcification is new. I am fully asymptomatic with high energy, no signs of CHF or other trouble. I have had a mitral “click” or murmur for 30 years w/no indication of trouble. DM2,mild. CKD, mild. Longterm bradycardia. Prescription meds: Glipizide, chlorthalidone, Atenolol. Thank you for your responses here. Very useful.
Hi Dr. , my grandma is diagnosed mitral annular calcification and she is 80 years old. The doctors are unwilling to perform surgery on her due to her age, should the age matter tho? I dont know how to save her without the surgery! Thanks,
I am a 70 yr old woman with CAD. A recent test showed I am in a 99% category for calcium. How dangerous is this? What percentage would be considered good, and should I, perhaps, not consume dairy products? Or has that ship sailed already?
Hi doctor. I am 24 yr old, female. I am diagnosed with thickened mitral valve leaflets and mitral valve calcification. I am also diagnosed with Cardiac Dysrhythmia. What does it mean? Thank youu
Hi are you a Filipino?
We’re the same echo report
Hi doctor. I am 24 yr old, female. I was diagnosed with thickened mitral valve leaflets and mitral valve calcification. I am also diagnosed with Cardiac Dysrhythmia. What does it mean? Thank youu
Results from echo were:
1. Estimated ejection fraction is >55%.
2. Mild thickening/calcification of the mitral anterior and posterior leaflets.
3. Mild mitral valve regurgitation.
4. Mild tricuspid regurgitation.
5. The left ventricular ejection fraction is normal.
I have pvc’s controlled with atenolol 100 mg twice daily
Hypertension controlled with lisinopril 20/25.
I’m curious about prognosis
Should be a good prognosis.
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Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
My son is 27 years old. He complained of chest pains last April. After the doctors initial comment that he is too young to have anything wrong with his heart and verbally dismissed the idea, he did an echo. He said it was normal. Fast forward 3 months, my son was and is still coughing up blood and another clinic pulled that echo from last April and it said he had a calcified mitral valve and enlarged left ventricle. We are now waiting to see a specialist. Could the coughing up blood be from the enlarged left ventricle and calcified mitral valve? Why would a doctor tell us the test was normal when this diagnosis was written there for him to simply read to us? How dangerous is this?
I failed to say that it has now been 10 months since the echo and he has several 20 to 30 minute coughing fits daily for 8 months
Does mild calcification always get severe and require surgery? I am 42 and a echocardiogram showed mild calcification.
I had a ministroke with small infarcts in the left and right side of the brain. In testing from a Cardiac CT Scan, the diagnosis was Severe annular calcification/caseous necrosis. Could this have been the cause of the emboli and what should be done about it? I am worried about another stroke. Thanks.
Dr A, about 2 weeks ago, I had a TIA. Luckily, it did not leave me with saying deficits That led to many tests, including a cardiac CT scan. That showed Severe annular calcification/caseous necrosis, causing restricted motion of posterior mitral leaflet. My blood pressure is under control with meds and I get strenuous exercise {20 mile bike rides} two times a week. I am aim 80 year old male who is worried about another stroke. Do you have recommendations.. Surgical or non surgical? Best option?
my wife 75 years old had a mitral valve replacement thru open heart in 2/15/ 2022
1 day later they had to put a temporary aortic pump to increase blood pressure, 2 days after that she suffered a stroke from a piece of a highly calcified mitral ring entering her artery. on a recent er visit for weekness and vomiting the hospital noted after a ct scan,”dense mitral annular calcification”
is this a problem
My recent echo. Shows abnormal mitral valve and calcified mitral annulus
.my bp has been running 180/110 to 220/120
I get short of breath on extertion. What does this mean..
Hello Dr. Ahmed, I am a 50 year old woman who just had a calcium score ct scan. My score was = 1 in LAD and zero in all other arteries. Extra arterial calcifications:
Aortic : none
Mitral annular: mild
Thoracic aorta: mild
Pericardium: none
I have normal cholesterol, take 5mg crestor per week, normal BP, normal a1c. BMI 23.5. Walk 30 min per day moderate – brisk pace. No symptoms other than occasionally I get heart palpitations that last a few seconds. Do you suggest I follow up with a cardiologist for further work up regarding the mitral annular finding? If so what time frame is appropriate for monitoring?
Thank you for your time.
S. Herc
I have Mitral Annular Calcification with mild mitral regurgation. My symptom usually is just a chest pain that only last in seconds and then gone. Should I be worried? how can i overcome this?
My husband had an echo done, and it stated nonrheumatic mitral annulus calif./ athscl heart disease of native coronary artery w/o and pctrs. He has had 2 stents and a quadruple bypass is that something i have to worry about?
Hi, respected doctor,
I had a coronary angiogram on 8 March 2023 . The result is :
1. Mid LAD has calcified plaque with MK7 when taking Calcium supplements ?
Your reply will be much appreciated.
My recent Echo said
1. Mild MR
2. MV normal leaflets normal mobility
3. Mild Annular Calac
Is there any cause for concern at this point. Im a 64 year old male.
Hi Dr. Im diagnosed with Thickened Mitral valve leaflets without restriction in motion and Mitral annular calcification and my heart rate is below 60 my resting heart rate is 50 is my heart is in danger?
I am a 49yr old woman that has been for the last 2wks feeling fluttering, chest pressure off and on with some nausea, lightheaded at times and could resemble anxiety like symptoms. No pain. BP is up to 140 at times. I have had a lexiscan that came back normal. I had an Echo 45 done which came back with normal LV stystolic function with EF 60-65%. Sclerosis of the aortic valve. Trace mitral regurgitaion. Mild calcification of the mitral valve annulus. Overall, I was told that all is normal other than the findings that are due to change of age. I have another test scheduled for Friday Carotid Duplex. I still feel bad and even have upper back pain that may or not be related. I still feel unease what are your thoughts on the matter?
I am a healthy 47 year old woman, I’ve never smoked, do not drink alcohol on the reg, eat a gluten-free diet and try to take the best care of myself. At my last physical, an abnormal EKG noted atrial bigeminy. I had it checked through an echocardiogram which found mild mitral annual calcification.
My results are below:
What would be your opinion? I am scheduled to have a CT scan of my heart to rule out heart disease. Does it seem atypical that a woman of my health status would have this? I’m stumped.
My left ventricle function is normal. Left Atrial Diameter: (1.5 – 4.0) 3.0 cm Posterior Wall Thickness: (0.6 – 1.1) 0.8
Aortic Diameter: (2.0 – 3.7) 2.7 cm Septal Thickness: (0.6 – 1.1) 0.8
LV Systolic Dimension: (2.4 – 4.0) 2.9 cm Ejection Fraction: (55 – 75)56
LV Diastolic Dimension: (3.7 – 5.6) 4.1 cm LVOT:
Left Ventricle: Normal
LV Internal Dimension: Normal
LV Systolic Function: Normal (EF > 55%)
LV Diastolic Function: Normal
LV Thickness: No Left Ventricular Hypertrophy
LV Wall Motion: Normal
LV Wall Motion Abnormalities: None
Right Ventricle: Normal Size, Function, Thickness
Atria: Both atria are normal size
Right Atrium: IAS bowing noted; does not meet criteria for atrial septal aneurysm
Aortic Valve: Normal
AV Valve Structure: Trileaflet
Mitral Valve: Borderline
MV Regurgitation: Trace
MV Annulus: Calcium mild
Tricuspid Valve: Normal
TV Result: Normal structure/function
TV Regurgitation: Trace
Pulmonic Valve: Normal
PV Result: Normal structure and function
Pulmonic Artery: Normal in diameter
Pericardium: Normal
Aorta: Normal
Inferior Vena Cava: normal in size with normal inspiratory collapse (assume RAP 3mmHg)
IMPRESSION: Borderline
Left Ventricular systolic function is Normal (EF > 55%).
Mild mitral annular calcification.
Please advise.
I had tricuspid valve repair and mild mitral leak for years. Now I have mild mitral valve annular calcification. mild concentric left ventricular hypertrophy and irregular EKG for 2 years now and palpitations. is all of this ok and not to worry about
Does calcification of the mitral valve, allow for valve replacement as an option. My wife has had two balloon procedures, and once again the valve is leaking. They are saying that because of the calcification repair might not be possible.
Hello – I was told my echo was normal, however upon reading the results saw that I have MAC, trivial prolapse on anterior leaflet and no stenosis or regurgitation. Is this a ticking time bomb, in what percentage of people does this progress to moderate/severe and in what percentage does the calcium break off? Can it be reversed or stabilized, from what I’m reading no, extremely worried, 55 yr old female. Thanks
Good evening. My mom just received an echocardiogram and her doctor said she may have a ‘possible calcification on her left ventricle’. She has had high blood pressure from an anti-anxiety she had been taking but has since stopped using it and is taking two meds to bring her numbers down, which seems to be working. Her doc also wants her to get her kidneys checked. Aside from a strange bout of vertigo a while ago, she has had no symptoms that i know of. Thoughts/ideas? TY
I’m 36 years old female..with mild valve regugation,3 valves and only arotic valve being healthy and having mirtal annual calcification. Feeling dizzy, palpitations,chest pain and pounding feeling in my neck vein
Hello Dr. Mustafa Ahmed. I have read these and your replies and would like to sincerely thank you for being engaged and actually responding to questions! what a rare and valuable thing. Much appreciated!
My recent echo showed the following issues with the Mitral valve…all other areas were fine.
-leaflets mildly sclerotic with normal mobility
– Mild anterior leaflet prolapse
– Moderate mitral valvular regurgitation
Could these issues be addressed with medication, and would they be likely to get worse over time?
Cheers
I am a 52-YO Female, type 1 diabetic since I was 18 YO. Well controlled diabetes A1C of 6.2 last time. On a TTE Complete the report says: Mitral Valve structure appears normal. Mild mitral thickening. There is mitral annular calcification. Trace valvular regurgitation. No stenosis. – Should I be concern about the “mild mitral thickening” and the “mitral annular calcification”?
Hello: Appreciate the article. It explained everything in a clear non- medical terminology and enlightened me. Compliments to the author for specific information. I am 78 year old woman w this condition. I also fit the patient category perfectly.