Which feature distinguishes MAC from calcification related to rheumatic fever?

Which feature distinguishes MAC from calcification related to rheumatic fever?

• A. Placement of the calcification
• B. Size of the calcification
• C. Pattern of calcification
• D. Patient age

Answer: (A)

The key idea is where the calcification sits. Mitral annular calcification forms a ring around the mitral annulus, typically at the base of the valve (often the posterior annulus). Calcification from rheumatic fever, by contrast, tends to involve the valve leaflets and their chordae, appearing as irregular or patchy calcifications along the leaflets and along commissural areas rather than as a continuous annular ring. On ultrasound, this annular, circumferential pattern distinguishes MAC from rheumatic-related calcification. Size and age can vary but do not define the difference as clearly as the location of the calcification.

The key idea is where the calcification sits. Mitral annular calcification forms a ring around the mitral annulus, typically at the base of the valve (often the posterior annulus). Calcification from rheumatic fever, by contrast, tends to involve the valve leaflets and their chordae, appearing as irregular or patchy calcifications along the leaflets and along commissural areas rather than as a continuous annular ring. On ultrasound, this annular, circumferential pattern distinguishes MAC from rheumatic-related calcification. Size and age can vary but do not define the difference as clearly as the location of the calcification.