Caseous calcification of the mitral annulus presenting as recurrent strokes

Although caseous calcification of the mitral annulus is usually diagnosed incidentally, it can cause embolic complications. The current report describes the case of caseous calcification revealed by recurrent episodes of stroke in a 64-year-old female patient. After her last ischemic episode, cerebr...

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Bibliographic Details
Published in:Journal of cardiology cases 2023-04, Vol.27 (4), p.184-187
Main Authors: Zymatoura, Maria-Erato, Georgiadou, Panagiota, Perlepe, Kalliopi, Tsiapras, Dimitrios, Katsilouli, Spyridoula, Voudris, Vassilis, Iakovou, Ioannis
Format: Article
Language:English
Subjects:
Case Report
Caseous calcification
Mitral annulus
Recurrent strokes
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Summary:Although caseous calcification of the mitral annulus is usually diagnosed incidentally, it can cause embolic complications. The current report describes the case of caseous calcification revealed by recurrent episodes of stroke in a 64-year-old female patient. After her last ischemic episode, cerebral magnetic resonance imaging confirmed the presence of a thrombus in the right middle cerebral artery. Transthoracic echocardiogram revealed calcification of the mitral annulus and an echo-dense mass with mobile borders fixed posteriorly. Transesophageal echocardiogram allowed better evaluation of the lesion. A medical approach was preferred, with no recurrence thereafter. Caseous calcification of the mitral annulus is a rare form of mitral annular calcification which is associated with high risk of strokes. Medical management with optimal anticoagulation can be effective over long-term follow up.
ISSN:1878-5409
1878-5409
DOI:10.1016/j.jccase.2022.12.014