Mitral Annulus Calcification

PA and lateral chest radiographs of an 80-year-old woman show an inverted "C"-shaped calcification over the heart in a characteristic location of the mitral valve.

Facts: Mitral Annulus Calcification

• Noninflammatory chronic degenerative process
• Mitral valve ring (annulus) may calcify in older individuals (>60 years)
• Women more common than men

Pattern on Imaging

• Small calcium forms in or below mitral annulus at junction between ventricular myocardium and posterior mitral leaflet
• Severe disease resembles the letter J, O, or reversed C

Clinical Significance

• Little clinical significance in most cases
• May grow into ventricular myocardium to produce heart block, into mitral leaflets to cause mitral regurgitation and stenosis, through endocardium to cause small systemic emboli
• Mitral annulus calcification in the elderly is an independent risk factor of developing stroke

Reference:

Miller SW, Boxt LM, Abbara S. Cardiac Imaging the Requisites. 2009.