Abstract
A 60-year-old female with a 3-year history of hemodialysis was hospitalized to undergo detailed gastrointestinal tract examinations.
A gastrointestinal series disclosed no definite abnormalites but a round dense echogenic mass was identified at the annular position of the posterior mitral leaflet by two-dimensional echocardiography. On pulmonary arteriography, the calcified mass projected into the left atrium and was observed to be subendocardial. Selective coronary angiography showed no abnormal vessels. We could not completely rule out cardiac tumor but there was a slight possibility of tumor embolism. The patient was discharged and followed. Two months later, the patient died of cerebral bleeding. Autopsy disclosed that the mass consisted of muddy nodular calcinosis.
Mitrai annular calcification (MAC) is a degenerative change which occurs mainly in older patients. Some studies have reported a frequent occurrence of MAC in patients with chronic renal failure. Abnormal calcium-phosphorus metabolism has been suggested as the most likely cause. On radiographs, MAC are generally “J”, “C”, or “U”-shaped. We have found no other reports of this type of nodular calcinosis in the heart in a patient on maintenance hemodialysis.
