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Mitral annulus calcification with a mobile component as a possible source of embolism
R Shohat-Zabarski1, R Paz, Y Adler
1Sheingarten Echocardiography Unit, Department of Cardiology, Rabin Medical Center, Beilinson Campus, Petah-Tiqva; Sacler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Insights
Mitral annulus calcification (MAC) can cause embolic events. A mobile component of MAC may directly lead to embolism, suggesting a causal link in some patients.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Mitral annulus calcification (MAC) is linked to embolic events, but the exact mechanism remains unclear.
- Understanding the pathophysiology of MAC-associated embolism is crucial for patient management.
Observation:
- Four patients with embolic events presented with MAC on transesophageal echocardiography.
- A mobile, echogenic component within the MAC was observed in these patients.
- Three patients had no other identifiable risk factors for embolism.
Findings:
- The mobile component of MAC resolved in three patients upon follow-up echocardiography.
- This dynamic change suggests the mobile component is directly implicated in embolic phenomena.
- The findings support MAC as a potential direct cause of embolism.
Implications:
- This study provides evidence for a direct causal role of MAC in embolic events.
- It highlights the importance of identifying mobile components in MAC for risk assessment.
- Further research into the management of mobile MAC is warranted.
Abstract:
Mitral annulus calcification has been associated with embolic events, but the precise pathophysiology has not been elucidated. The authors describe four patients who experienced embolic events whose transesophageal echocardiograms showed a mitral annulus calcification, with a mobile component that exhibited the same echogenicity as the calcification. Three patients had no other conditions known to be associated with embolism. On follow-up transesophageal echocardiography, the mobile component of the mitral annulus calcification had disappeared in three patients. These findings support the hypothesis that mitral annulus calcification not only is associated with but also is possibly a direct cause of embolic events in some patients.