CASEOUS MITRAL ANNULAR calcification (CMAC) is an uncommon variant of mitral annular calcification. This case demonstrates the need for a high level of clinical suspicion in order to correctly diagnose CMAC, as it could be easily mistaken for an atrial tumor, an abscess, or a vegetation. Making the correct diagnosis of CMAC can facilitate the implementation of appropriate treatment strategies, which could potentially reduce cerebral vascular accidents. Additionally, the use of multimodal imaging in characterizing such intracardiac masses is essential.