AMA Category 1 Credit for Physicians Only.
ASRT CME is not available.
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The leaflets are thin where the leaflets have not been invaded with calcium. The calcium deposition occurs in the left atrial wall, mitral annulus, and the posterior mitral valve leaflet. The anterior leaflet appears to be spared.
MAC or mitral annular calcification, is a disease of calcium deposition in the mitral annulus that leads to mitral regurgitation more often than mitral stenosis. If a valve can't open normally, it typically can't close normally either. MAC was followed in one study and found that if MAC tended to become more severe with rapid progression the younger the patient at the time of diagnosis. Mitral stenosis with progression of a gradient occurred in 50% of these patients.
If the MV and AV are calcified, then the coronary arteries had a high calcium score as well. AV calcification or AV/MV calcification tended to be associated with isolated LAD disease whereas RCA disease tended to be associated with MAC or AV/MV calcification - however, there was a signifiicant amount of crossover.
MAC can also be associated with intramural hematomas, endocarditis, necrosis, and thrombus formation.
The matrix-GIa protient, a vitamin K dependent protien, is a potent inhibitor of tissue calcification. Coumadin use has been associated with an increase risk of MV or AV calcification.
|Please answer the following questions correctly to obtain your CME.|
Mitral annular calcium causing mitral stenosis.
Association between mitral and aortic valve calcification and preferential left or right coronary artery disease.
Left atrial intramural haematoma associated with mitral annular calcification.
Mobile ventricular thrombus arising from the mitral annulus in patients with dense mitral annular calcification.
Infective endocarditis on mitral annular calcification: a case report.
Liquefaction necrosis of calcified mitral annulus.
Warfarin use and the risk of valvular calcification.