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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 ]
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] Treatment: Medication, Mitral valve repair, Mitral valve replacement, MitraClip
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.
For individuals with few symptoms, or those with contraindications to surgery, options exist for medical treatment in both mitral insufficiency and mitral valve stenosis, although they won't cure the conditions. Such medical treatments include diuretics, [45] [46] vasodilators, [46] [45] and ACE inhibitors. [45] [47] [48]
If the atrium dilates and gets really large it can compress its neighbor, the esophagus, and patients might have difficulty swallowing solid foods, called dysphagia. For patients with severe problems related to mitral regurgitation or stenosis, treatment involves valve repair or surgical replacement of the valve.
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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