About 6% of persons > 60 yr, predominantly women, have mitral annular calcification. Calcification prevents annular systolic contrac¬tion and may limit valve leaflet closure. Although the mitral regurgita¬tion is rarely hemodynamically significant, conduction disturbances may result from extension of the calcification. Recent data suggest thai such calcification doubles the risk for stroke, independent of other risk lac tors.
Patients are often asymptomatic. An apical systolic murmur that radiates widely, occasionally to the back, is associated with a soft first heart sound. Characteristic findings on chesl x-ray and dense horse¬shoe-shaped calcificalions on echocardiography define the condition. Patients rarely require therapy other than that needed to control the ventricular response rate to atrial fibrillation.