What's the most likely diagnosis?

• 72 year-old with shortness of breath

1. Calcification of the Aortic Valve
2. Tuberculosis
3. Pericardial Calcification
4. Calcification of the Mitral Annulus
5. Calcification of the Mitral Leaflets

Answer:

 

4. Calcification of the Mitral Annulus

 

 

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Calcification of the Mitral Annulus

Mitral annulus frequently calcifies over the age of 60

• One of the most common cardiac calcifications
• Has been considered to be a degenerative process
• Calcification is actually subvalvular in location
• Associations
  • Aortic stenosis
  • Hypertrophic cardiomyopathy
  • Chronic renal failure, especially of those on dialysis
  • Bacterial endocarditis
  • Systemic hypertension
  • Diabetes mellitus
  • Hypercholesterolemia
• It may be associated with significant atherosclerosis
• In one study, it was found to be associated with twice the risk of stroke, independent of other risk factors
• In another study, it was associated with an increased prevalence of coronary artery disease in patients <65

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