Document Detail

Calcification of the mitral annulus: etiology, clinical associations, complications and therapy.
MedLine Citation:
PMID:  156499     Owner:  NLM     Status:  MEDLINE    
This report reviews the clinical features of 80 patients with roentgenographically proved mitral annular calcification. The mean age of the group was 73 years, and there was a 2.5 to 1 female to male ratio. Evaluation for underlying cardiovascular disease revealed six patients with severe calcific valvular aortic stenosis; five patients with hypertrophic cardiomyopathy, 11 with mitral prolapse and 33 with significant arterial hypertension (blood pressure greater or equal to 150/96 mm Hg). Eighty-five per cent of the group (68 of 80 patients) had an underlying cardiac disorder associated with either chronically increased left ventricular systolic pressure or abnormal leaflet motion. Other cardiovascular abnormalities occurring as complications secondary to the mitral ring calcification included subacute bacterial endocarditis (three cases), arterial emboli (five episodes) and high grade atrioventricular block (16 cases). Twelve patients had severe mitral regurgitation; successful mitral valve replacement was carried out in four patients (all with myxomatous mitral tissue). Evidence of diffuse conduction system disease, not limited to the area of the cardiac fibrous skeleton, was found frequently (44 patients). Nine patients had sinus node dysfunction and 35 patients had electrocardiographic evidence of distal intraventricular (fascicular) block. Twenty-one patients eventually required pacemakers for management of symptomatic bradyarrhythmias. Atrial fibrillation was present in 23 patients. In this review it was found that calcification of the mitral annulus is frequently associated with or induces serious cardiovascular disease. Since some of these disorders may be modified by appropriate therapy, calcification of the mitral annulus should no longer be ignored as a benign marker of the elderly heart.
P K Fulkerson; B M Beaver; J C Auseon; H L Graber
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of medicine     Volume:  66     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  1979 Jun 
Date Detail:
Created Date:  1979-08-29     Completed Date:  1979-08-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  967-77     Citation Subset:  AIM; IM    
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MeSH Terms
Aortic Valve Stenosis / radiography
Arrhythmias, Cardiac / diagnosis
Calcinosis / radiography*
Cardiomegaly / radiography
Heart Catheterization
Hypertension / diagnosis
Middle Aged
Mitral Valve / radiography*
Mitral Valve Insufficiency / radiography
Mitral Valve Prolapse / radiography
Pacemaker, Artificial

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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