Hello!
Welcome on HCM!
I understand your concern and would like to explain that mitral valve calcification, especially mitral anulus is not a rare finding in elderly individual, those with chronic
renal disease, etc.
Nevertheless, returning to your concrete issue of concern:
mitral regurgitation, I would explain that when acoustic shadowing is present due to excessive calcification, mitral regurgitation visualization on color Doppler could be sub-optimal.
Coming to this point, additional echo techniques such as spectral Doppler analysis, and evaluation of possible impact of chamber dilation could be a clue to clarify this issue.
In addition, in case trans-thoracic echo is not sufficient at providing satisfactory data, then a trans-esophageal echo would be necessary.
You should discuss with your doctor on the above mentioned issues.
Hope to have been helpful!
Kind regards,
Dr. Iliri