Images in Cardiovascular Medicine Serial Cardiac Magnetic Resonance Imaging of a Rapidly Progressing Liquefaction Necrosis of Mitral Annulus Calcification Associated With Embolic Stroke

Mitral annulus calcification (MAC) is a common findingin the elderly. A rare manifestation of MAC is lique-faction necrosis that can be mistaken for a tumor or an abscess. Because its course is most often benign, a correct diagnosis is imperative to avoid unnecessary workup or treatment. Case A 76-year-old woman with history of hypertension and dyslipidemia presented with chest pain and elevated cardiac enzymes. A coronary angiogram revealed no significant coronary artery disease. Echocardiogram (Figure 1) revealed a large, solid mass within the atrioventricular groove and the lateral wall of the left ventricle. There was moderate calcification of the mitral valve annulus. Computed tomography scan of the chest (Figure 2) revealed a soft tissue density inseparable from th