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.
Abbreviations:
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)Keywords
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Article info
Publication history
Published online: January 07, 2023
Accepted:
December 25,
2022
Received in revised form:
December 4,
2022
Received:
September 19,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
