Mitral annular calcification (MAC) is a chronic degenerative condition that is associated with age, chronic kidney disease, diabetes, dyslipidemia, hypertension, and tobacco use. Mobile calcified lesions can be mistaken for endocarditis on trans-thoracic echocardiogram (TTE), creating a unique diagnostic challenge. In this case, we describe a young dialysis patient who presented with dyspnea on exertion with no obvious etiology on initial work-up. TTE was obtained, which showed mobile lesions on the mitral and aortic valves, initially thought to be endocarditis, but later diagnosed as MAC. Trans-esophageal echocardiography (TEE) is a useful modality to differentiate mobile masses on the mitral valve.
Keywords: echocardiography; end stage renal disease; endocarditis; mitral annular calcification.