Mitral annulus calcification (MAC) is an age-related degenerative process, which rarely has any clinical significance. Calcium is actually deposited in a perivalvular location and when heavy enough can interfere with mitral valve function. It occurs in 10-50% of dialysis patients and is associated with elevated calcium-phosphorus product, vascular calcification, Hypercalcemia, and hyperphosphatemia. MAC is accelerated by hypertension, Diabetes mellitus, and genetic abnormalities of fibrous skeleton of the heart, such as Marfans’ syndrome.