Related Experiment Videos
Bacterial endocarditis complicating mitral annular calcification: a clinical and echocardiographic study
Jean-Christophe Eicher1, Laurence De Nadai, Francois-Xavier Soto
1Department of Cardiology, University Hospital, Dijon, France. jean-christophe.eicher@chu-dijon.fr
The Journal of Heart Valve Disease
|April 17, 2004
Summary
Mitral annular calcification (MAC) is an underestimated cause of severe bacterial endocarditis. This condition presents uniquely and has a high mortality rate, highlighting the need for improved diagnosis.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Imaging
Background:
- Endocarditis on mitral annular calcification (MAC) is rarely reported during life.
- Previous data primarily stems from necropsy studies.
- Understanding its clinical and echocardiographic features is crucial.
Purpose of the Study:
- To determine the frequency of bacterial endocarditis complicating MAC.
- To identify specific clinical and echocardiographic features of this condition.
Main Methods:
- Prospective collection of data from 62 native mitral valve infective endocarditis cases.
- Diagnosis confirmed using multiplane transesophageal echocardiography (TEE).
- Comparison between endocarditis on MAC (group 1) and leaflet endocarditis (group 2).
Main Results:
- 15% of patients had endocarditis originating from MAC.
- MAC-related endocarditis showed higher rates of diabetes, cancer, and neurological presentation (febrile coma/meningoencephalitis).
- Echocardiography revealed larger vegetations, calcium-dense echoes, ring abscesses, and para-annular leakage, with a 53% in-hospital mortality.
Conclusions:
- MAC is an underappreciated risk factor for severe bacterial endocarditis.
- This specific type of endocarditis has distinct clinical and echocardiographic characteristics.
- Multiplane TEE is vital for improving the understanding and diagnosis of MAC-related endocarditis.