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Mitral annular calcification

Here is parasternal long axis view obtained from a patient with diabetes mellitus and chronic kidney disease with altered bone mineral metabolism. Note the hyperechoic calcification along the posterior mitral annulus with prominent shadowing. There is some calcification of mitral chordae as well. Labeled images and a few points pertinent to nephrology below.

Here are similar images from an end-stage renal disease patient. In addition to mitral annular calcification, you can see concentric left ventricular hypertrophy and aortic stenosis (valve is not opening completely and has some calcification). Images obtained using a handheld ultrasound machine.

More examples:

Another example: PLAX view demonstrating, left ventricular hypertrophy, MAC (arrowhead) as well as pericardial effusion. Obtained from a patient with ESRD presenting with volume overload.

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