INTRACARDIAC CALCIFICATION WITH CARDIAC CONDUCTION DEFECTS IN A CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENT – AN INTERESTING CASE REPORT

Abstract

Mitral annular calcication (mac) is a chronic degenerative process of the brous support structure of the mitral valve. The reported prevalence of mac is about 8% in an unselected, general population and increases with age, in the presence of cardiovascular risk factors. It is also observed that mac has a female gender predominance with a prevalence of 12%.Its clinical relevance comes from mac's association with an increased rate of mortality and cardiovascular disease (cvd). Occasionally, a chest x-ray might reveal calcic demarcation of the mitral annulus. Mac is usually seen as a c-, j-, u- or o-shape, with the open part lying at the site of the aortic outow tract. Lateral projection usually better demonstrates mitral calcication because the overlying spine and main left lower lobe arteries in the posteroanterior view may mask its visualization. Fluoroscopy during coronary angiography can also show mitral calcication, but is not an accurate modality for assessment of the extent of mac. Mac is usually an incidental nding in patients being evaluated for cardiovascular or pulmonary diseases. The presence of a calcied mitral annulus is asymptomatic, which precludes true evaluation of the prevalence of mac in the general population. We are presenting a case report of a female patient who is a known case of chronic obstructive pulmonary disease and had an incidental nding of mitral annular calcication on chest radiograph that was later conrmed by computed tomography (ct) and 2d echo ndings.