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Published on: August 28, 2018
Caseous calcification of the mitral annulus associated with stroke: report of two cases
S Sagnier1, M Poli2, M Oysel-Mestre3
1Unité neuro-vasculaire, CHU de Bordeaux, place Amélie Raba-Léon, 33076 Bordeaux cedex, France; Unité neuro-vasculaire, pôle de neurosciences cliniques, hôpital Pellegrin, université Bordeaux Segalen, CHU de Bordeaux, place Amélie Raba-Léon, 33000 Bordeaux, France.
Insights
Caseous calcification of the mitral annulus (CCAM) may be a source of stroke, even when other causes are absent. This rare condition warrants careful management of vascular risk factors.
Area of Science:
- Cardiology
- Neurology
- Radiology
Background:
- Caseous calcification of the mitral annulus (CCAM) is a rare complication of mitral annulus calcification (MAC).
- The role of CCAM in stroke etiology is debated, with some viewing it as a stroke source and others as an atherosclerosis marker.
Objective:
Caseous calcification of the mitral annulus (CCAM) is a rare complication of mitral annulus calcification (MAC). Whether CCAM should be considered as a cardiac source of stroke or a simple marker of atherosclerosis remains a matter of debate.
Method:
Herein, we report two patients with stroke and CCAM.
Results:
The first one was associated with extensive aortic arch atheroma, while CCAM was the only potential cause in the second case. Transthoracic echocardiography was normal in both cases and CCAM was diagnosed on transesophageal echocardiography.
Conclusion:
These observations suggest that CCAM should be added to the list of minor cardioembolic sources of stroke but also requires a perfect control of vascular risk factors.
