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Mobile components associated with rapidly developing mitral annulus calcification in patients with chronic renal
Howard J Willens1, Alexandre C Ferreira, Anthony J Gallagher
1Division of Cardiology, Department of Medicine, University of Miami School of Medicine, Jackson Memorial Hospital, Miami, Florida, USA. hwillens@med.miami.edu
Insights
Mitral annulus calcification with mobile components can cause strokes. This condition, common in end-stage renal disease patients, may develop rapidly but can also resolve.
Area of Science:
- Cardiology
- Nephrology
- Neurology
Background:
- Mitral annulus calcification (MAC) is a potential source of emboli causing cerebrovascular accidents (CVAs).
- Cardiovascular calcifications, including MAC, are prevalent in end-stage renal disease (ESRD) and can progress rapidly.
Observation:
- Two patients with ESRD presented with mobile components associated with MAC.
- Serial echocardiography revealed rapid development of MAC in these patients.
Findings:
- Echocardiography confirmed mobile components on MAC, suggesting embolic potential.
- Follow-up imaging in one patient showed resolution of these mobile elements, indicating dynamic changes.
Implications:
- This highlights a potential mechanism for CVAs in ESRD patients with MAC.
- The dynamic nature of MAC and its mobile components warrants further investigation and monitoring.
Abstract:
Mitral annulus calcification may directly cause cerebrovascular accidents by serving as a source of calcific or thrombotic emboli. This hypothesis has been supported by recent reports of mobile components associated with mitral annulus calcification detected by echocardiography. Cardiovascular calcifications, including mitral annulus calcification, are common in end-stage renal disease and may develop and progress over a short period of time. We report two patients with mobile components associated with mitral annulus calcification and end-stage renal disease. Serial echocardiography documented that the mitral annulus calcification in these two patients had developed rapidly. Follow-up echocardiography in one patient demonstrated resolution of the mobile elements.