Caseous Intracardiac Calcification: A Diagnostic Enigma

Abstract

Intramyocardial calcification is a rare phenomenon often only discovered on postmortem. We describe the case of a healthy 69-year-old lady diagnosed with idiopathic caseous intracardiac calcification extending from the mitral valve annulus. We present high-quality images and propose an investigatory template for future cases.

Chameleonic appearance of caseous calcification of the mitral valve – still a problem for its appropriate management

“…Although cases of CCMA embolization were reported in the literature [1,4,10,27], due to surface thrombus formation, calcified material embolization and/or fistulization with necrotic material embolization, it is considered to be a benign entity and conservative treatment is usually recommended [28,29]. Surgical management is recommended in cases with significantly impaired valve function (severe stenosis and/or regurgitation), in cases with evidence of systemic embolism and in doubtful cases, when the diagnosis is not clear [1,18].…”

“…We present hereby a case of caseous calcification of the mitral valve annulus and posterior cusp, which was diagnosed as papillary fibroelastoma, known to induce embolization [10].…”