Which statement best describes MAC?

Which statement best describes MAC?

• A. MAC primarily involves the LV wall
• B. MAC primarily involves the Mitral annulus with leaflets usually sparingly calcified unless severe
• C. MAC affects the tricuspid valve
• D. MAC is a disease of the aortic valve

Answer: (B)

Mitral annular calcification is calcification of the fibrous ring around the mitral valve, not the LV wall. It tends to cluster along the mitral annulus, often the posterior portion, and the leaflets themselves are usually not heavily calcified unless the disease is severe. On ultrasound, you’d see a bright, dense rim at the annulus with possible shadowing; only in advanced cases does the calcification extend toward the leaflets and can contribute to mitral stenosis or regurgitation. The statement that best describes MAC is the one that highlights the annular location and notes that leaflets are sparingly calcified unless the disease is severe. Other choices would imply involvement of the LV wall, the tricuspid valve, or the aortic valve, which is not characteristic of MAC.

Mitral annular calcification is calcification of the fibrous ring around the mitral valve, not the LV wall. It tends to cluster along the mitral annulus, often the posterior portion, and the leaflets themselves are usually not heavily calcified unless the disease is severe. On ultrasound, you’d see a bright, dense rim at the annulus with possible shadowing; only in advanced cases does the calcification extend toward the leaflets and can contribute to mitral stenosis or regurgitation. The statement that best describes MAC is the one that highlights the annular location and notes that leaflets are sparingly calcified unless the disease is severe. Other choices would imply involvement of the LV wall, the tricuspid valve, or the aortic valve, which is not characteristic of MAC.