Abstract
A 77-year-old woman presented for assessment of symptomatic mitral regurgitation. Multimodality cardiac imaging revealed severe mitral regurgitation secondary to mitral valve prolapse. Significant mitral annular calcification with dramatic intramyocardial calcification was also incidentally discovered. She was then given a diagnosis of idiopathic cardiac osseous metaplasia and was managed conservatively. (Level of Difficulty: Advanced.).