Caseous calcification of the mitral annulus presenting as recurrent strokes. Issue 4 (April 2023)

• Record Type: Journal Article
• Authors: Zymatoura, Maria-Erato; Georgiadou, Panagiota; Perlepe, Kalliopi; Tsiapras, Dimitrios; Katsilouli, Spyridoula; Voudris, Vassilis; Iakovou, Ioannis
• Is Part Of: Journal of cardiology cases. Volume 27:Issue 4(2023)
• Page Start: 184
• Page End: 187
• Publication Date: 2023-04
• Subjects: MAC Mitral annulus calcification -- CCMA Caseous calcification of the mitral annulus -- TOE Transesophageal echocardiographic evaluation -- CT Computed tomography -- MRI Magnetic resonance imaging -- TTE Transthoracic echocardiogram -- AV Atrioventricular; Caseous calcification -- Mitral annulus -- Recurrent strokes; Cardiology -- Periodicals; Cardiovascular Diseases -- Case Reports; Cardiovascular Diseases -- Periodicals; Cardiology -- Case Reports; Cardiology -- Periodicals; Cardiology; Electronic journals; Periodicals; 616.12
• DOI: 10.1016/j.jccase.2022.12.014
• Languages: English
• ISSNs: 1878-5409

Abstract

Abstract: 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. Learning objective: 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.