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Mitral annular calcification (MAC) is a multifactorial chronic degenerative process in which calcium with lipid is deposited in the annular fibrosa ring of the heart's mitral valve. MAC was first discovered and described in 1908 by M. Bonninger in the journal Deutsche Medizinische Wochenschrift. [1]
Once symptoms of mitral stenosis begin to develop, progression to severe disability takes 9.2 ± 4.3 years. [ citation needed ] In individuals having been offered mitral valve surgery but refused, survival with medical therapy alone was 44 ± 6% at 5 years, and 32 ± 8% at 10 years after they were offered correction.
Acute mitral regurgitation, chronic compensated mitral regurgitation, chronic decompensated mitral regurgitation [2] Causes mitral valve prolapse , ageing , rheumatic fever , mitral annular calcification , infective endocarditis , hypertrophic cardiomyopathy [ 2 ]
Other causes are mitral degenerative disease, severe calcification (elderly), congenital deformities, malignant carcinoid syndrome, neoplasm, left atrial appendage thrombus, endocarditic vegetations, certain inherited metabolic diseases, or complications of previous procedures at the aortic valve. [5]
This test can also show leaflet calcification and the pressure gradient over the mitral valve. [32] Severe mitral stenosis is defined as a mitral valve area <1.5 cm 2. [8] Progressive mitral stenosis has a normal valve area but will have increased flow velocity across the mitral valve. [8]
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Rarely there can be a severe form of calcification of the mitral valve annulus that can be mistaken for an intracardiac mass or thrombus. [18] Mitral disease can be classified using Carpentier's classification which is based on the leaflet motion. Type I pertains to normal leaflet motion.
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