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Massive cerebral embolism originated from ruptured infective mitral annular calcification in a chronic hemodialysis

Junichi Nishida1, Takuto Maeda, Satoshi Yuda

  • 1Second Department of Internal Medicine, Sapporo Medical University School of Medicine, Chuo-ku, Sapporo, Japan. yuda@sapmed.ac.jp

Echocardiography (Mount Kisco, N.Y.)
|November 20, 2008
PubMed

Insights

Infective endocarditis can affect mitral annular calcification (MAC), potentially causing severe cerebral embolism. This case highlights a hemodialysis patient with massive brain embolism from a ruptured infective MAC.

Area of Science:

  • Cardiology
  • Neurology
  • Nephrology

Background:

  • Infective endocarditis of mitral annular calcification (MAC) is a recognized complication.
  • The link between infective MAC and cerebral embolism is less frequently emphasized.

Observation:

  • A chronic hemodialysis patient presented with symptoms of massive cerebral embolism.
  • Imaging revealed a ruptured infective mitral annular calcification as the source.

Findings:

  • The patient's massive cerebral embolism was directly attributed to a ruptured infective MAC.
  • This case underscores the embolic potential of infective MAC, particularly in vulnerable populations.

Implications:

  • Highlights the need to consider infective MAC as a source of cerebral embolism, especially in hemodialysis patients.
  • Suggests enhanced vigilance for cardiac source of embolism in patients with MAC and neurological deficits.
  • Emphasizes the importance of early diagnosis and management of infective MAC to prevent catastrophic embolic events.

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