What is it Mitral Annular Calcification?

 In Cardiovascular

Mitral Annular Calcification or “MAC” for short, effects the mitral valve, this is a process that happens overtime which involves the fibrous annulus (ring around) of the mitral valve. MAC occurs when progressive calcium deposits form along and beneath the annulus.

Why does it happen?

MAC can happen due to the aging process, atherosclerosis (plaque build- up in the arteries), or if minerals are altered during metabolism as well increased mechanical stress.

What are possible symptoms?

Usually there are no symptoms and it is discovered as an incidental finding during other testing. However, if MAC is extensive then it may cause mitral stenosis (narrowing of mitral valve), mitral regurgitation (backflow of blood through a valve) or both.

What are risk factors and for developing MAC?

  1. Age
  2. Atherosclerosis
  3. Conditions that increase mitral valve stress including hypertension, aortic stenosis and hypertrophic cardiomyopathy
  4. Abnormal mineral metabolism with calcium-phosphorus, common with chronic kidney disease and dialysis
  5. Congenital metabolic disorders such as Marfan syndrome and Hurler syndrome

Potential complications?

Possible associations with MAC and atherosclerosis can lead to adverse cardiac events such as stroke and arrhythmias.

Advanced cases of MAC may cause obstruction of the left ventricular inflow system and mitral stenosis.

What are possible treatments?

The management strategy for MAC is targeted at reducing risk factors associated with MAC such as cholesterol control, arrhythmia management, and blood pressure control.

Where can I get more information?

For additional information, please seek further guidance from your primary care provider or cardiologist


Freeman, R.V. (2018). Clinical Manifestations and diagnosis of mitral annular calcification. In C.M. Otto & S.B. Yeon (Eds.), UptoDate.  Available from  https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-mitral-annular-calcification?search=mitral%20annular%20calcification&source=search_result&selectedTitle=1~41&usage_type=default&display_rank=1

Mitral Annulus Calcification

Yigal Abramowitz, Hasan Jilaihawi, Tarun Chakravarty, Michael J. Mack, Raj R. Makkar. Journal of the American College of Cardiology Oct 2015, 66 (17) 1934-1941; DOI: 10.1016/j.jacc.2015.08.872

Recent Posts