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Home / Heart Disease / Heart Valves / Mitral Annular Calcification
Mitral Annular Calcification

Mitral Annular Calcification

February 3, 2015 by Dr. Mustafa Ahmed 77 Comments

What is the Mitral Annulus?

At myheart.net we’ve helped millions of people through our articles and answers. Now our authors are keeping readers up to date with cutting edge heart disease information through twitter. Follow Dr Ahmed on Twitter @MustafaAhmedMD

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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.

Mitral Annulus

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.

Mitral Annular Calcification

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.

Caseous Calcification of the Mitral Annulus

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.

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Filed Under: Heart Valves Tagged With: heart valve, Mitral valve

Comments

  1. Renee Hennigar says

    November 21, 2016 at 5:06 pm

    Very helpful.
    Thank You

    Reply
  2. Roberta says

    December 3, 2016 at 5:28 pm

    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.

    Reply
    • Dr. Mustafa Ahmed says

      December 3, 2016 at 7:58 pm

      I wouldn’t worry about the mitral annular calcification for now. At some point an echocardiogram would be advised.

      Reply
      • Roberta Blankenship says

        December 19, 2016 at 5:29 pm

        Thank you for responding. The cancer was ruled out. Thank God! Do you recommend anything further for now?

        Reply
  3. Brit says

    December 8, 2016 at 2:15 am

    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.

    Reply
    • Brit says

      December 8, 2016 at 2:20 am

      I forgot to mention it was sudden cardiac death.

      Reply
    • Dr. Mustafa Ahmed says

      December 8, 2016 at 7:08 am

      What was the stated cause of death, the valve disease in this setting is very unlikely to have contributed.

      Reply
      • Brit says

        December 8, 2016 at 5:53 pm

        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.

        Reply
      • Chad says

        May 3, 2019 at 10:59 pm

        My echocardiography says mild posterior mitral annular calcification with unrestricted valve opening
        What is this?

        Reply
        • Dr. Mustafa Ahmed says

          May 20, 2019 at 4:24 am

          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.

          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.

          Reply
  4. pramod says

    December 25, 2016 at 3:17 am

    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

    Reply
    • Dr. Mustafa Ahmed says

      December 27, 2016 at 12:05 am

      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.

      Reply
      • pramod says

        February 11, 2017 at 3:59 pm

        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

        Reply
        • Pramod Dinkar Prabhudesai says

          December 30, 2021 at 7:52 pm

          My mitral valve 75% calcified I wish to know is there any effective nonsurgical treatment for above problem .

          Reply
  5. Katherine Bailey says

    January 27, 2017 at 1:08 pm

    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?

    Reply
    • Dr. Mustafa Ahmed says

      January 28, 2017 at 4:52 am

      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.

      Reply
  6. Jordan says

    February 9, 2017 at 7:09 am

    Hi. Is dense MAC with mild to moderate mitral regurgitation something to be worried about?

    Reply
    • Dr. Mustafa Ahmed says

      February 11, 2017 at 5:31 am

      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.

      Reply
  7. pramod says

    February 12, 2017 at 2:36 am

    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

    Reply
    • Dr. Mustafa Ahmed says

      February 13, 2017 at 5:41 am

      If i were seeing a similar case, i would do a TEE as the next step with 3D to characterize the valve more accurately.

      Reply
  8. Marge says

    March 22, 2017 at 6:03 am

    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.

    Reply
    • Dr. Mustafa Ahmed says

      March 23, 2017 at 4:15 am

      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/

      Reply
    • BBBaxter says

      December 10, 2021 at 8:25 pm

      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)

      Reply
  9. nanak says

    March 30, 2017 at 6:55 pm

    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.

    Reply
  10. nanak says

    March 31, 2017 at 4:58 pm

    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.

    Reply
    • Dr. Mustafa Ahmed says

      April 1, 2017 at 3:13 am

      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.

      Reply
      • nanak says

        April 1, 2017 at 6:09 am

        Respected doctor, How will i know if she needs valvuloplasty or valve replacement surgery? thanks for replying.

        Reply
  11. Candi Simmons says

    July 29, 2017 at 2:43 am

    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

    Reply
    • Dr. Mustafa Ahmed says

      July 30, 2017 at 3:50 am

      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.

      If you are interested in information and therapy for heart disease then feel free to follow my twitter at @MustafaAhmedMD

      Reply
  12. Loney Scharnatta says

    August 13, 2017 at 5:18 am

    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?

    Reply
    • Dr. Mustafa Ahmed says

      August 13, 2017 at 5:33 am

      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.

      Reply
      • Sharon says

        November 21, 2019 at 10:07 pm

        Ridiculonodular opacity middle lobe & mitral valve calcification. Could they be related?

        Reply
      • Suzy says

        April 6, 2021 at 6:59 am

        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?

        Reply
        • Dr. Mustafa Ahmed says

          April 25, 2021 at 12:10 pm

          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.

          Reply
  13. saravanan says

    August 23, 2017 at 7:09 pm

    very good information. Thank you.

    Reply
  14. Oli cruz says

    November 22, 2017 at 9:20 pm

    is mitral and aortic annular calcification progressive? Are there risks involved during surgery with the presence of calcifications?

    Reply
    • Dr. Mustafa Ahmed says

      November 23, 2017 at 8:08 am

      Which surgery are you referring to?

      In general it is felt to be a chronic, somewhat progressive process.

      Reply
  15. Iseult says

    December 9, 2017 at 12:05 am

    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.

    Reply
    • Dr. Mustafa Ahmed says

      December 10, 2017 at 5:36 am

      In many instances calcification does not preclude valve repair, make sure you are seeing an expert reference mitral surgeon.

      you can follow my twitter at @MustafaAhmedMD

      Reply
  16. Gia Jilani says

    December 18, 2017 at 11:26 am

    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.

    Reply
  17. Sam hashmi says

    February 5, 2018 at 9:09 am

    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

    Reply
    • Dr. Mustafa Ahmed says

      February 10, 2018 at 7:19 am

      If the dr is not worried and there is no tightening or leak of the valve then there is likely no concern.

      you can follow my twitter at @MustafaAhmedMD

      Reply
  18. Steve Cole says

    March 22, 2018 at 6:41 am

    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.

    Reply
    • Dr. Mustafa Ahmed says

      March 25, 2018 at 5:59 am

      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/

      Reply
  19. ravi says

    March 26, 2018 at 7:19 am

    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

    Reply
    • Diane says

      July 29, 2018 at 3:05 am

      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.

      Reply
  20. Carolyn Mclellan says

    August 17, 2018 at 12:31 am

    Thank you very much.

    Reply
    • Dr. Mustafa Ahmed says

      August 19, 2018 at 9:38 pm

      you can follow our twitter at @MustafaAhmedMD

      Reply
  21. Michelle Lawrence says

    February 12, 2019 at 6:50 pm

    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

    Reply
    • Michelle Lawrence says

      February 12, 2019 at 6:59 pm

      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]

      Reply
  22. L.Farrow says

    March 27, 2019 at 5:16 pm

    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

    Reply
    • Dr. Mustafa Ahmed says

      April 7, 2019 at 7:04 am

      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.

      Reply
      • Tabitha Filer says

        May 20, 2019 at 3:21 am

        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”

        Reply
  23. Marta says

    April 30, 2019 at 8:42 pm

    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?

    Reply
    • Dr. Mustafa Ahmed says

      August 5, 2019 at 5:37 am

      Although theoretically that would make sense to some degree, its not known whether cholesterol meds prevent rate of annular calcification.

      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.

      Reply
  24. Mike Raemaeker says

    June 4, 2019 at 12:58 am

    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

    Reply
    • Dr. Mustafa Ahmed says

      July 7, 2019 at 5:17 am

      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.

      Reply
  25. Divya Khanna says

    June 17, 2019 at 8:54 pm

    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

    Reply
    • Dr. Mustafa Ahmed says

      July 7, 2019 at 6:43 am

      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.

      Reply
  26. Debra Waddle says

    June 22, 2019 at 10:58 pm

    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.

    Reply
  27. Divya Khanna says

    June 29, 2019 at 9:00 pm

    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.

    Reply
    • Dr. Mustafa Ahmed says

      August 1, 2019 at 5:31 am

      Where is he based?

      Do you have details of the echo report?

      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.

      Reply
  28. Lhe-an Gollingoy says

    October 30, 2019 at 11:46 am

    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

    Reply
  29. U S Ghosh says

    November 28, 2019 at 6:22 am

    What will be the first heart sound intensity in mitral annular or valvular calcification in elderly female patients without any mitral stenosis

    Reply
  30. Holly says

    March 4, 2020 at 2:14 am

    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!

    Reply
    • Dr. Mustafa Ahmed says

      April 12, 2020 at 9:58 pm

      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.

      Reply
  31. Viel Madrid says

    December 17, 2020 at 7:34 pm

    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.

    Reply
    • Dr. Mustafa Ahmed says

      January 10, 2021 at 6:01 pm

      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?

      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.

      Reply
  32. Renee says

    February 25, 2021 at 4:06 pm

    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?

    Reply
  33. Yvette says

    March 26, 2021 at 2:26 am

    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.?

    Reply
    • Dr. Mustafa Ahmed says

      April 25, 2021 at 12:16 pm

      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?

      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.

      Reply
  34. Joana Paula Tolentino says

    November 29, 2021 at 9:29 am

    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

    Reply
  35. Joana Paula Tolentino says

    November 29, 2021 at 9:30 am

    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

    Reply
  36. Benjamin Cox says

    January 8, 2022 at 5:41 pm

    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

    Reply
    • Dr. Mustafa Ahmed says

      February 6, 2022 at 11:52 pm

      Should be a good prognosis.

      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.

      Reply

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